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Distinct characteristics and outcomes in elderly-onset IgA vasculitis (Henoch-Schönlein purpura) with nephritis: Nationwide cohort study of data from the Japan Renal Biopsy Registry (J-RBR)
http://hdl.handle.net/10458/00010503
http://hdl.handle.net/10458/00010503a5cb8f5c-6d7f-42d5-a28e-2c2617f08e27
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本文 (2.5 MB)
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| Item type | 学術雑誌論文 / Journal Article(1) | |||||
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| 公開日 | 2023-02-20 | |||||
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| タイトル | Distinct characteristics and outcomes in elderly-onset IgA vasculitis (Henoch-Schönlein purpura) with nephritis: Nationwide cohort study of data from the Japan Renal Biopsy Registry (J-RBR) | |||||
| 言語 | en | |||||
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| 言語 | eng | |||||
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| 資源タイプ | journal article | |||||
| 著者 |
小松, 弘幸
× 小松, 弘幸× 藤元, 昭一× Maruyama, Shoichi× Mukoyama, Masashi× Sugiyama, Hitoshi× Tsuruya, Kazuhiko× 佐藤, 寛× Soma, Jun× Yano, Junko× Itano, Seiji× Nishino, Tomoya× Sato, Toshinobu× Narita, Ichiei× Yokoyama, Hitoshi |
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| 抄録 | ||||||
| 内容記述タイプ | Abstract | |||||
| 内容記述 | Background: The clinical presentation and prognosis of adult and elderly patients with IgA vasculitis （Henoch-Scho¨nlein purpura） accompanied by nephritis （IgAV-N） have not been investigated in detail. We therefore surveyed the features and outcomes of IgAV-N based on nationwide data derived from the Japan Renal Biopsy Registry （J-RBR）. |
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| 内容記述タイプ | Abstract | |||||
| 内容記述 | Methods: This multi-center cohort study compared the clinicopathological parameters at diagnosis, initial therapies and outcomes between 106 adult （age 19–64 years） and 46 elderly （65 years） patients with IgAV-N who were registered in the J-RBR between 2007 and 2012. The primary end-points comprised a 50% increase in serum creatinine （sCr） values or end-stage kidney disease. Factors affecting a decrease in renal function were assessed using Cox proportional hazards models. |
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| 内容記述タイプ | Abstract | |||||
| 内容記述 | Results: Rates of hypertension, impaired renal function, hypoalbuminemia and crescentic glomerulonephritis were significantly higher among the elderly, than the adult patients. About 80% and 60% of the patients in both groups were respectively treated with corticosteroid and a reninangiotensin system （RAS） blockade. Both groups had favorable renal survival rates for nine years （93.6% and 91.4% of the adult and elderly patients, respectively）. Significantly more elderly than adult patients developed a 50% increase in sCr during a mean observation period of 3.9 years （21.7% vs. 4.7%, p = 0.012）, and significantly fewer elderly, than adult patients achieved clinical remission （23.9% vs. 46.2%, p = 0.016）. Multivariate analysis selected advanced age （65 years） and lower serum albumin values as independent prognostic factors for a decline in renal function, whereas steroid pulse therapy helped to preserve renal function. |
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| 内容記述タイプ | Abstract | |||||
| 内容記述 | Conclusions: The renal prognosis of adult and elderly patients with IgAV-N was favorable when treated aggressively with corticosteroid and RAS blockade. However, the course of renal function should be carefully monitored in patients aged over 65 years and those with hypoalbuminemia. |
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| 書誌情報 |
en : PLOS ONE 巻 13, 号 5, p. e0196955, 発行日 2018-05-08 |
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| 出版者 | Public Library of Science | |||||
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| 収録物識別子タイプ | ISSN | |||||
| 収録物識別子 | 19326203 | |||||
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| 関連タイプ | isIdenticalTo | |||||
| 識別子タイプ | PMID | |||||
| 関連識別子 | 29738576 | |||||
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| 関連タイプ | isIdenticalTo | |||||
| 識別子タイプ | DOI | |||||
| 関連識別子 | https://doi.org/10.1371/journal.pone.0196955 | |||||
| 権利 | ||||||
| 権利情報 | © 2018 Komatsu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited | |||||
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| 識別子タイプ | DOI | |||||
| 関連識別子 | https://doi.org/10.1371/journal.pone.0196955 | |||||
| 関連名称 | Publisher's web site | |||||
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| 内容記述タイプ | Other | |||||
| 内容記述 | application/pdf | |||||
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| 出版タイプ | VoR | |||||
