Clinical and histological features of lupus nephritis in Japan: A cross-sectional analysis of the Japan Renal Biopsy Registry (J-RBR)
Clinical and histological features of lupus nephritis in Japan: A cross-sectional analysis of the Japan Renal Biopsy Registry (J-RBR)
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DOI：
10.1111/nep.12863
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发表时间：
2017-11-01
期刊：
影响因子：
2.5
通讯作者：
Nojima, Yoshihisa
中科院分区：
文献类型：
--
作者：
Hiromura, Keiju;Ikeuchi, Hidekazu;Nojima, Yoshihisa
目的狼疮性肾炎（LN）的临床和组织学特征是高度可变的，取决于种族和民族。日本肾活检登记（J-RBR）是一个全国性的肾活检登记。在这里，我们报告了日本LN使用J-RBR数据库的横断面分析。方法在J-RBR登记的18463例患者中，选取331例首次行肾活检的LN患者，根据ISN/RPS 2003分类对其临床特征进行分析。结果331例LN患者中位年龄为37岁（女性占81.3%）。各ISN/RPS类的频次分别为：I， 1.2%；二世,7.9%;Iii (v), 25.1%；Iv-s (v), 13.0%；Iv-g (+/- v), 31.1%；V, 20.8%;VI, 0.9%。蛋白尿水平和肾病综合征患病率在IV-G级（+/- V）中最高。当I、II和VI类被排除在分析之外时，IV-G类（+/- V）与较低的eGFR和更严重的血尿显著相关。结论：这项全国性的研究显示，IV-G （+/- V）型LN是日本最常见的LN形式，并伴有严重的临床肾脏表现。本横断面研究使用日本肾活检登记报告了2007-2012年331例狼疮性肾炎患者的首次肾活检。ISN/RPS IV-G级最常被检测到，并伴有最显著的临床表现。
AimThe clinical and histological features of lupus nephritis (LN) are highly variable, depending on race and ethnicity. The Japan Renal Biopsy Registry (J-RBR) is a nationwide registry of renal biopsies. Here, we report a cross-sectional analysis of Japanese LN using the J-RBR database.MethodsOut of 18463 patients registered in the J-RBR, 331 LN patients, who received renal biopsy for the first time, were extracted and their clinical features were analyzed according to the ISN/RPS 2003 classification.ResultsThe median age of the 331 LN patients was 37years (women, 81.3%). The frequencies of each of the ISN/RPS Classes were as follows: I, 1.2%; II, 7.9%; III (V), 25.1%; IV-S (V), 13.0%; IV-G (+/- V), 31.1%; V, 20.8%; and VI, 0.9%. The level of proteinuria and the prevalence of nephrotic syndrome were highest for Class IV-G (+/- V). When Classes I, II, and VI were excluded from the analysis, Class IV-G (+/- V) was significantly associated with a lower eGFR and severer haematuria than the other classes.ConclusionThis nationwide study revealed that Class IV-G (+/- V) was the most prevalent form of LN in Japan and was associated with a severe clinical renal presentation.Summary at a Glance This cross sectional study using the Japan Renal Biopsy Registry reports on 331 first renal biopsies on patients with lupus nephritis from 2007-2012. ISN/RPS Class IV-G was most commonly detected and was accompanied by the most significant clinical presentation.