研究2017.10.13
【IgA腎症コホート研究】 田中茂先生の原著論文が Nephrol Dial Transplant 誌に掲載されました！
田中茂先生（H14）の原著論文が Nephrol Dial Transplant 誌に掲載されました．
腎生検の時期によって3群［1979–89 (n＝232), 1990–99 (n＝574) and 2000–10 (n＝449).に分け，末期腎不全に至る頻度を比較したところ，1000人年あたり11.5，6.5，4.2と減少が認められ，その原因として，早期診断と早期のステロイド治療の効果が示唆されることを報告しました．
Abstract
Background:
There are limited data on secular trends in the incidence of end-stage renal disease (ESRD) and frequencies of its risk factors or treatment modalities in patients with immunoglobulin A nephropathy (IgAN).
Methods:
This study divided 1255 patients with IgAN into three groups according to the timing of renal biopsy: 1979-89 ( n = 232), 1990-99 ( n = 574) and 2000-10 ( n = 449). The age-adjusted incidence rates, incidence rate ratios and 95% confidence intervals (CIs) for ESRD were calculated by the person-year method and compared using Poisson regression analysis.
Results:
A total of 63 patients (5.0%) developed ESRD. The age-adjusted incidence of ESRD decreased significantly over time, i.e. 11.5 per 1000 person-years (95% CI 5.4-24.6) in 1979-89, 6.5 per 1000 person-years (95% CI 1.0-25.2) in 1990-99 and 4.2 per 1000 person-years (95% CI 1.0-17.7) in 2000-10. The proportions of patients with preserved renal function and acute-stage inflammatory histologic changes (i.e. endocapillary hypercellularity and extracapillary proliferation) at the timing of biopsy increased over time, as did the rates of prescriptions of renin-angiotensin system blockers and corticosteroids (all P for trend <0.05). The effect of acute inflammatory histologic lesions on renal prognosis was drastically reduced over time.
Conclusions:
These findings suggest that early diagnosis in the acute inflammatory phase and subsequent aggressive treatment may have contributed to the significant downward trend in the incidence of ESRD in patients with IgAN over three decades.
