Nationwide multicenter kidney biopsy study of Japanese patients with hypertensive nephrosclerosis

Research Group of Diabetic Nephropathy and Nephrosclerosis, Ministry of Health, Labour and Welfare of Japan, and Japan Agency for Medical Research and Development

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Nephrosclerosis is an increasingly reason for dialysis in Japan. However, kidney biopsy specimens for hypertensive nephrosclerosis are very limited; thus, the pathologic evaluation of hypertensive nephrosclerosis currently remains unclear. Methods: Clinical and pathologic data of a total of 184 biopsy-confirmed hypertensive nephrosclerosis patients were collected from 13 centers throughout Japan. Seven pathological findings were assessed in this study. The outcomes of interest for this study were dialysis, composite kidney events, cardiovascular events, and all-cause mortality. Results: The Green and Yellow (G&Y), Orange, and Red groups of the chronic kidney diseases (CKD) heat map contained 36, 57, and 91 cases, respectively. The mean observation period was 7.3 ± 5.2 (median, IQR; 6.1, 2.6–9.7) years. Global glomerulosclerosis (GScle), interstitial fibrosis and tubular atrophy (IFTA), arteriolar hyalinosis in Red exhibited higher scores than those in G&Y and Orange. The incidence rates of the composite kidney end points in 100 person-years for the G&Y, Orange, and Red groups were 1.42, 2.16, and 3.98, respectively. In the univariate Cox analysis for the composite kidney end points, GScle, IFTA and interstitial cell infiltration exhibited statistically significant high hazard ratios (1.18, 1.84, 1.69, respectively). However, after adjustment for clinical and medication data, the Red group in the CKD heat map category was risk factor for the composite kidney end points (HR 9.51). Conclusions: In summary, although pathologic findings had minor impacts on the prediction of composite outcomes in this study, the clinical stage of the CKD heat map is a good predictor of composite kidney events.

Original languageEnglish
Pages (from-to)629-637
Number of pages9
JournalClinical and Experimental Nephrology
Volume22
Issue number3
DOIs
Publication statusPublished - Jun 1 2018

Fingerprint

Nephrosclerosis
Kidney
Biopsy
Chronic Renal Insufficiency
Hot Temperature
Atrophy
Dialysis
Japan
Fibrosis
Outcome Assessment (Health Care)
Observation
Mortality
Incidence

Keywords

  • CKD heat map
  • Hypertension
  • Kidney biopsy
  • Nephrosclerosis

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

Research Group of Diabetic Nephropathy and Nephrosclerosis, Ministry of Health, Labour and Welfare of Japan, and Japan Agency for Medical Research and Development (2018). Nationwide multicenter kidney biopsy study of Japanese patients with hypertensive nephrosclerosis. Clinical and Experimental Nephrology, 22(3), 629-637. https://doi.org/10.1007/s10157-017-1496-4

Nationwide multicenter kidney biopsy study of Japanese patients with hypertensive nephrosclerosis. / Research Group of Diabetic Nephropathy and Nephrosclerosis, Ministry of Health, Labour and Welfare of Japan, and Japan Agency for Medical Research and Development.

In: Clinical and Experimental Nephrology, Vol. 22, No. 3, 01.06.2018, p. 629-637.

Research output: Contribution to journalArticle

Research Group of Diabetic Nephropathy and Nephrosclerosis, Ministry of Health, Labour and Welfare of Japan, and Japan Agency for Medical Research and Development 2018, 'Nationwide multicenter kidney biopsy study of Japanese patients with hypertensive nephrosclerosis', Clinical and Experimental Nephrology, vol. 22, no. 3, pp. 629-637. https://doi.org/10.1007/s10157-017-1496-4
Research Group of Diabetic Nephropathy and Nephrosclerosis, Ministry of Health, Labour and Welfare of Japan, and Japan Agency for Medical Research and Development. Nationwide multicenter kidney biopsy study of Japanese patients with hypertensive nephrosclerosis. Clinical and Experimental Nephrology. 2018 Jun 1;22(3):629-637. https://doi.org/10.1007/s10157-017-1496-4
Research Group of Diabetic Nephropathy and Nephrosclerosis, Ministry of Health, Labour and Welfare of Japan, and Japan Agency for Medical Research and Development. / Nationwide multicenter kidney biopsy study of Japanese patients with hypertensive nephrosclerosis. In: Clinical and Experimental Nephrology. 2018 ; Vol. 22, No. 3. pp. 629-637.
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AU - Shimizu, Miho

AU - Yuzawa, Yukio

AU - Hara, Akinori

AU - Toyama, Tadashi

AU - Kitamura, Hiroshi

AU - Suzuki, Yoshiki

AU - Sato, Hiroshi

AU - Uesugi, Noriko

AU - Ubara, Yoshifumi

AU - Hoshino, Junichi

AU - Hisano, Satoshi

AU - Ueda, Yoshihiko

AU - Nishi, Shinichi

AU - Yokoyama, Hitoshi

AU - Nishino, Tomoya

AU - Kohagura, Kentaro

AU - Ogawa, Daisuke

AU - Mise, Koki

AU - Shibagaki, Yugo

AU - Kimura, Kenjiro

AU - Haneda, Masakazu

AU - Makino, Hirofumi

AU - Matsuo, Seiichi

AU - Wada, Takashi

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N2 - Background: Nephrosclerosis is an increasingly reason for dialysis in Japan. However, kidney biopsy specimens for hypertensive nephrosclerosis are very limited; thus, the pathologic evaluation of hypertensive nephrosclerosis currently remains unclear. Methods: Clinical and pathologic data of a total of 184 biopsy-confirmed hypertensive nephrosclerosis patients were collected from 13 centers throughout Japan. Seven pathological findings were assessed in this study. The outcomes of interest for this study were dialysis, composite kidney events, cardiovascular events, and all-cause mortality. Results: The Green and Yellow (G&Y), Orange, and Red groups of the chronic kidney diseases (CKD) heat map contained 36, 57, and 91 cases, respectively. The mean observation period was 7.3 ± 5.2 (median, IQR; 6.1, 2.6–9.7) years. Global glomerulosclerosis (GScle), interstitial fibrosis and tubular atrophy (IFTA), arteriolar hyalinosis in Red exhibited higher scores than those in G&Y and Orange. The incidence rates of the composite kidney end points in 100 person-years for the G&Y, Orange, and Red groups were 1.42, 2.16, and 3.98, respectively. In the univariate Cox analysis for the composite kidney end points, GScle, IFTA and interstitial cell infiltration exhibited statistically significant high hazard ratios (1.18, 1.84, 1.69, respectively). However, after adjustment for clinical and medication data, the Red group in the CKD heat map category was risk factor for the composite kidney end points (HR 9.51). Conclusions: In summary, although pathologic findings had minor impacts on the prediction of composite outcomes in this study, the clinical stage of the CKD heat map is a good predictor of composite kidney events.

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KW - CKD heat map

KW - Hypertension

KW - Kidney biopsy

KW - Nephrosclerosis

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