Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Aichi, Japan.
J Nephrol. 2023 Nov;36(8):2257-2267. doi: 10.1007/s40620-023-01687-9. Epub 2023 Aug 19.
The Japan Renal Biopsy Registry (J-RBR), a nationwide, web-based, registry system, started in 2007. This study aimed to summarise the epidemiology of biopsy-diagnosed kidney disease in Japan over 10 years.
We analysed the J-RBR database, from 2007 to 2017. Patients' clinical data collected at the time of biopsy and histopathological diagnoses were used for epidemiological and clinicopathologic analyses.
The predominant renal biopsy diagnoses were immunoglobulin A nephropathy (39.2%), lupus nephritis (6.5%) and minimal change disease (6.0%) in younger adults (19-64 years), and membranous nephropathy (17.4%), antineutrophil cytoplasmic antibody-associated vasculitis or anti-glomerular basement membrane glomerulonephritis (13.0%), and immunoglobulin A nephropathy (12.5%) in older adults (≥ 65 years). The percentages of patients diagnosed with membranoproliferative glomerulonephritis and immunoglobulin A nephropathy decreased, whereas those with immunoglobulin A vasculitis and diabetic nephropathy increased over the decade. In paediatric patients (< 19 years), immunoglobulin A nephropathy (36.1%), minimal change disease (17.6%), and immunoglobulin A vasculitis (8.6%) were the predominant diagnoses. The percentage of patients diagnosed with immunoglobulin A vasculitis increased over the decade. Based on the sex distribution, minimal change disease and membranous nephropathy were predominant in men aged < 20 and > 40 years, respectively, whereas immunoglobulin A vasculitis and antineutrophil cytoplasmic antibody-associated vasculitis or anti-glomerular basement membrane glomerulonephritis were predominant in women in their 20s and 30s and aged < 50 years, respectively. Immunoglobulin A nephropathy was predominant in men at most ages and in women in their 20s to 40s.
This study describes the distribution and changes in kidney biopsy diagnoses over 10 years in Japan and paves the way for future research on kidney diseases in adults and children.
日本肾脏活检注册研究(J-RBR)是一个全国性的基于网络的注册系统,于 2007 年启动。本研究旨在总结日本 10 年来肾脏活检诊断疾病的流行病学。
我们分析了 2007 年至 2017 年 J-RBR 数据库。使用活检时收集的患者临床数据和组织病理学诊断结果进行流行病学和临床病理分析。
在年轻成人(19-64 岁)中,主要的肾脏活检诊断为免疫球蛋白 A 肾病(39.2%)、狼疮肾炎(6.5%)和微小病变性肾病(6.0%),而在老年成人(≥65 岁)中,主要的诊断为膜性肾病(17.4%)、抗中性粒细胞胞浆抗体相关性血管炎或抗肾小球基底膜肾小球肾炎(13.0%)和免疫球蛋白 A 肾病(12.5%)。在过去的十年中,膜增生性肾小球肾炎和免疫球蛋白 A 肾病的诊断百分比有所下降,而免疫球蛋白 A 血管炎和糖尿病肾病的诊断百分比有所上升。在儿科患者(<19 岁)中,主要的诊断为免疫球蛋白 A 肾病(36.1%)、微小病变性肾病(17.6%)和免疫球蛋白 A 血管炎(8.6%)。在过去的十年中,免疫球蛋白 A 血管炎的诊断百分比有所上升。根据性别分布,在<20 岁和>40 岁的男性中,微小病变性肾病和膜性肾病分别占主导地位,而在 20 多岁和 30 多岁以及<50 岁的女性中,免疫球蛋白 A 血管炎和抗中性粒细胞胞浆抗体相关性血管炎或抗肾小球基底膜肾小球肾炎分别占主导地位。在大多数年龄段,免疫球蛋白 A 肾病在男性中占主导地位,在 20 多岁至 40 多岁的女性中也占主导地位。
本研究描述了日本 10 年来肾脏活检诊断的分布和变化,为成人和儿童肾脏病的未来研究奠定了基础。