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Point of no return (PNR) in progressive IgA nephropathy: Significance of blood pressure and proteinuria management up to PNR
http://hdl.handle.net/10458/2050
http://hdl.handle.net/10458/20503c3f078f-4cae-4f09-942b-6c05643da41d
| 名前 / ファイル | ライセンス | アクション |
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komatsuJN200511.pdf (422.4 kB)
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| Item type | 学術雑誌論文 / Journal Article(1) | |||||||||||||||||
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| 公開日 | 2009-06-30 | |||||||||||||||||
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| タイトル | Point of no return (PNR) in progressive IgA nephropathy: Significance of blood pressure and proteinuria management up to PNR | |||||||||||||||||
| 言語 | en | |||||||||||||||||
| 言語 | ||||||||||||||||||
| 言語 | eng | |||||||||||||||||
| キーワード | ||||||||||||||||||
| 言語 | en | |||||||||||||||||
| キーワード | End-stage renal disease, Hypertension, IgA nephropathy, Point of no return, Proteinuria | |||||||||||||||||
| 資源タイプ | ||||||||||||||||||
| 資源タイプ | journal article | |||||||||||||||||
| 著者 |
小松, 弘幸
× 小松, 弘幸
WEKO
7768
× 藤元, 昭一
WEKO
8142
× 佐藤, 祐二× 原, 誠一郎× 山田, 和弘× Morita, Satoshi× 江藤, 胤尚 |
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| 抄録 | ||||||||||||||||||
| 内容記述タイプ | Abstract | |||||||||||||||||
| 内容記述 | Background: Based on observations of the clinical course of patients with IgA nephropathy （IgAN）, D'Amico et al. proposed the concept of the `point of no return （PNR）', after which progression to end-stage renal disease （ESRD） becomes inevitable. They reported that the approximate PNR is 3.0 mg/dl serum creatinine （sCr）. Methods: To confirm the PNR and to clarify the factors affecting the deterioration of renal function in IgAN patients, we analyzed the sequential data of those with 1.2≦ sCr <2.0 mg/dl at renal biopsy. Forty-seven patients with moderate to severe histological lesions and whose 36 month follow-up did not require renal replacement therapy, were enrolled in this study. Results: None of the patients who once exceeded a sCr value of 2.0 mg/dl could return to below 2.0 mg/dl during the observation period. Kaplan-Meier analysis revealed that the renal outcome of patients with average values of MBP ≧102 mmHg and/or UP score ≧2.0 until 2.0 mg/dl sCr was significantly poor. Multivariate analysis using the Cox proportional hazards model, identified only MBP and UP during the course until 2.0 mg/dl sCr as independent prognostic factors for ESRD, having hazard ratios of 2.56 （per 10mmHg; 95% CI, 1.08 to 6.05） and 4.37 （per 0.5 point; 1.36 to 14.1）, respectively. Conclusions: We confirmed PNR as a sCr level of 2.0 mg/dl （equivalent to estimated glomerular filtration rate of 30 to 35 ml/min/1.73m2） during the course of IgAN in Japan. The management of both BP and UP until sCr has reached PNR is essential to arrest the progression to ESRD in IgAN. |
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| 言語 | en | |||||||||||||||||
| 書誌情報 |
en : Journal of Nephrology 巻 18, 号 6, p. 690-695, 発行日 2005-11 |
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| 出版者 | Wichtig Editore | |||||||||||||||||
| 言語 | en | |||||||||||||||||
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| 収録物識別子タイプ | ISSN | |||||||||||||||||
| 収録物識別子 | 11218428 | |||||||||||||||||
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| 収録物識別子タイプ | NCID | |||||||||||||||||
| 収録物識別子 | AA10737230 | |||||||||||||||||
| PubMed番号 | ||||||||||||||||||
| 関連タイプ | isVersionOf | |||||||||||||||||
| 識別子タイプ | PMID | |||||||||||||||||
| 関連識別子 | 16358226 | |||||||||||||||||
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| 出版タイプ | AM | |||||||||||||||||
