Renal disease in the elderly and the very elderly Japanese: Analysis of the Japan Renal Biopsy Registry (J-RBR)

Hitoshi Yokoyama, Hitoshi Sugiyama, Hiroshi Sato, Takashi Taguchi, Michio Nagata, Seiichi Matsuo, Hirofumi Makino, Tsuyoshi Watanabe, Takao Saito, Yutaka Kiyohara, Shinichi Nishi, Hiroyuki Iida, Kunio Morozumi, Atsushi Fukatsu, Tamaki Sasaki, Kazuhiko Tsuruya, Yukimasa Kohda, Makoto Higuchi, Hideyasu Kiyomoto, Shin GotoMotoshi Hattori, Hiroshi Hataya, Shoji Kagami, Norishige Yoshikawa, Yuichiro Fukasawa, Yoshihiko Ueda, Hiroshi Kitamura, Akira Shimizu, Kazumasa Oka, Naoki Nakagawa, Takafumi Ito, Shunya Uchida, Kengo Furuichi, Izaya Nakaya, Satoshi Umemura, Keiju Hiromura, Mitsuhiro Yoshimura, Nobuhito Hirawa, Takashi Shigematsu, Masafumi Fukagawa, Makoto Hiramatsu, Yoshio Terada, Osamu Uemura, Tetsuya Kawata, Akira Matsunaga, Aki Kuroki, Yasukiyo Mori, Koji Mitsuiki, Haruyoshi Yoshida

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background and objectives: Data regarding renal disease in the elderly (age ≥65 years old) and very elderly (age ≥80 years old) Japanese are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in elderly patients who underwent renal biopsy. Design, setting, participants, and measurements: From July 2007 to November 2011, all of the elderly native renal biopsy patients who had been registered in the Japan Renal Biopsy Registry (J-RBR; 2802 including 1596 males and 1206 females) were identified. Their data were compared with a control group of 7416 patients who ranged in age from 20 to 64 years old and were registered on the J-RBR over the same period. In addition, the clinical and pathological classifications of 276 very elderly patients were also analyzed. Results: The indications for biopsy were nephrotic syndrome (NS) in 36.2 and 50.7 % of the elderly and the very elderly patients, chronic nephritic syndrome in 31.8 and 17.4 %, and acute kidney injury including rapidly progressive glomerulonephritis in 18.6 and 22.5 %, respectively. Primary glomerular disease was the most frequent diagnosis, followed by MPO-ANCA-positive nephritis, IgA nephropathy (IgAN), and diabetic nephropathy. In primary GN including IgAN, membranous nephropathy (MN) was the most frequent histological type, followed by IgAN and minor glomerular abnormalities. A comparison with the control group showed that MN, MPO-ANCA-positive nephritis, and amyloid nephropathy were more common in the elderly (P < 0.001), and IgAN was less common (P < 0.001). As for nephrotic syndrome in the elderly, MN was the most common histological type, followed by minimal change NS, diabetic nephropathy, amyloid nephropathy, and focal segmental glomerulosclerosis. There was a significant discrepancy between the urinary protein/creatinine ratio and daily proteinuria after the 7th decade of life. Conclusions: Renal biopsy is a valuable diagnostic tool, even in elderly and very elderly Japanese patients. In the future, modified clinical guidelines for elderly renal disease should be developed.

Original languageEnglish
Pages (from-to)903-920
Number of pages18
JournalClinical and Experimental Nephrology
Volume16
Issue number6
DOIs
Publication statusPublished - Dec 1 2012

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Registries
Japan
Kidney
Biopsy
Membranous Glomerulonephritis
Immunoglobulin A
Antineutrophil Cytoplasmic Antibodies
Nephritis
Nephrotic Syndrome
Diabetic Nephropathies
Amyloid
Lipoid Nephrosis
Focal Segmental Glomerulosclerosis
Control Groups
Glomerulonephritis
Proteinuria
Acute Kidney Injury
Creatinine
Guidelines

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

Renal disease in the elderly and the very elderly Japanese : Analysis of the Japan Renal Biopsy Registry (J-RBR). / Yokoyama, Hitoshi; Sugiyama, Hitoshi; Sato, Hiroshi; Taguchi, Takashi; Nagata, Michio; Matsuo, Seiichi; Makino, Hirofumi; Watanabe, Tsuyoshi; Saito, Takao; Kiyohara, Yutaka; Nishi, Shinichi; Iida, Hiroyuki; Morozumi, Kunio; Fukatsu, Atsushi; Sasaki, Tamaki; Tsuruya, Kazuhiko; Kohda, Yukimasa; Higuchi, Makoto; Kiyomoto, Hideyasu; Goto, Shin; Hattori, Motoshi; Hataya, Hiroshi; Kagami, Shoji; Yoshikawa, Norishige; Fukasawa, Yuichiro; Ueda, Yoshihiko; Kitamura, Hiroshi; Shimizu, Akira; Oka, Kazumasa; Nakagawa, Naoki; Ito, Takafumi; Uchida, Shunya; Furuichi, Kengo; Nakaya, Izaya; Umemura, Satoshi; Hiromura, Keiju; Yoshimura, Mitsuhiro; Hirawa, Nobuhito; Shigematsu, Takashi; Fukagawa, Masafumi; Hiramatsu, Makoto; Terada, Yoshio; Uemura, Osamu; Kawata, Tetsuya; Matsunaga, Akira; Kuroki, Aki; Mori, Yasukiyo; Mitsuiki, Koji; Yoshida, Haruyoshi.

In: Clinical and Experimental Nephrology, Vol. 16, No. 6, 01.12.2012, p. 903-920.

Research output: Contribution to journalArticle

Yokoyama, H, Sugiyama, H, Sato, H, Taguchi, T, Nagata, M, Matsuo, S, Makino, H, Watanabe, T, Saito, T, Kiyohara, Y, Nishi, S, Iida, H, Morozumi, K, Fukatsu, A, Sasaki, T, Tsuruya, K, Kohda, Y, Higuchi, M, Kiyomoto, H, Goto, S, Hattori, M, Hataya, H, Kagami, S, Yoshikawa, N, Fukasawa, Y, Ueda, Y, Kitamura, H, Shimizu, A, Oka, K, Nakagawa, N, Ito, T, Uchida, S, Furuichi, K, Nakaya, I, Umemura, S, Hiromura, K, Yoshimura, M, Hirawa, N, Shigematsu, T, Fukagawa, M, Hiramatsu, M, Terada, Y, Uemura, O, Kawata, T, Matsunaga, A, Kuroki, A, Mori, Y, Mitsuiki, K & Yoshida, H 2012, 'Renal disease in the elderly and the very elderly Japanese: Analysis of the Japan Renal Biopsy Registry (J-RBR)', Clinical and Experimental Nephrology, vol. 16, no. 6, pp. 903-920. https://doi.org/10.1007/s10157-012-0673-8
Yokoyama, Hitoshi ; Sugiyama, Hitoshi ; Sato, Hiroshi ; Taguchi, Takashi ; Nagata, Michio ; Matsuo, Seiichi ; Makino, Hirofumi ; Watanabe, Tsuyoshi ; Saito, Takao ; Kiyohara, Yutaka ; Nishi, Shinichi ; Iida, Hiroyuki ; Morozumi, Kunio ; Fukatsu, Atsushi ; Sasaki, Tamaki ; Tsuruya, Kazuhiko ; Kohda, Yukimasa ; Higuchi, Makoto ; Kiyomoto, Hideyasu ; Goto, Shin ; Hattori, Motoshi ; Hataya, Hiroshi ; Kagami, Shoji ; Yoshikawa, Norishige ; Fukasawa, Yuichiro ; Ueda, Yoshihiko ; Kitamura, Hiroshi ; Shimizu, Akira ; Oka, Kazumasa ; Nakagawa, Naoki ; Ito, Takafumi ; Uchida, Shunya ; Furuichi, Kengo ; Nakaya, Izaya ; Umemura, Satoshi ; Hiromura, Keiju ; Yoshimura, Mitsuhiro ; Hirawa, Nobuhito ; Shigematsu, Takashi ; Fukagawa, Masafumi ; Hiramatsu, Makoto ; Terada, Yoshio ; Uemura, Osamu ; Kawata, Tetsuya ; Matsunaga, Akira ; Kuroki, Aki ; Mori, Yasukiyo ; Mitsuiki, Koji ; Yoshida, Haruyoshi. / Renal disease in the elderly and the very elderly Japanese : Analysis of the Japan Renal Biopsy Registry (J-RBR). In: Clinical and Experimental Nephrology. 2012 ; Vol. 16, No. 6. pp. 903-920.
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abstract = "Background and objectives: Data regarding renal disease in the elderly (age ≥65 years old) and very elderly (age ≥80 years old) Japanese are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in elderly patients who underwent renal biopsy. Design, setting, participants, and measurements: From July 2007 to November 2011, all of the elderly native renal biopsy patients who had been registered in the Japan Renal Biopsy Registry (J-RBR; 2802 including 1596 males and 1206 females) were identified. Their data were compared with a control group of 7416 patients who ranged in age from 20 to 64 years old and were registered on the J-RBR over the same period. In addition, the clinical and pathological classifications of 276 very elderly patients were also analyzed. Results: The indications for biopsy were nephrotic syndrome (NS) in 36.2 and 50.7 {\%} of the elderly and the very elderly patients, chronic nephritic syndrome in 31.8 and 17.4 {\%}, and acute kidney injury including rapidly progressive glomerulonephritis in 18.6 and 22.5 {\%}, respectively. Primary glomerular disease was the most frequent diagnosis, followed by MPO-ANCA-positive nephritis, IgA nephropathy (IgAN), and diabetic nephropathy. In primary GN including IgAN, membranous nephropathy (MN) was the most frequent histological type, followed by IgAN and minor glomerular abnormalities. A comparison with the control group showed that MN, MPO-ANCA-positive nephritis, and amyloid nephropathy were more common in the elderly (P < 0.001), and IgAN was less common (P < 0.001). As for nephrotic syndrome in the elderly, MN was the most common histological type, followed by minimal change NS, diabetic nephropathy, amyloid nephropathy, and focal segmental glomerulosclerosis. There was a significant discrepancy between the urinary protein/creatinine ratio and daily proteinuria after the 7th decade of life. Conclusions: Renal biopsy is a valuable diagnostic tool, even in elderly and very elderly Japanese patients. In the future, modified clinical guidelines for elderly renal disease should be developed.",
author = "Hitoshi Yokoyama and Hitoshi Sugiyama and Hiroshi Sato and Takashi Taguchi and Michio Nagata and Seiichi Matsuo and Hirofumi Makino and Tsuyoshi Watanabe and Takao Saito and Yutaka Kiyohara and Shinichi Nishi and Hiroyuki Iida and Kunio Morozumi and Atsushi Fukatsu and Tamaki Sasaki and Kazuhiko Tsuruya and Yukimasa Kohda and Makoto Higuchi and Hideyasu Kiyomoto and Shin Goto and Motoshi Hattori and Hiroshi Hataya and Shoji Kagami and Norishige Yoshikawa and Yuichiro Fukasawa and Yoshihiko Ueda and Hiroshi Kitamura and Akira Shimizu and Kazumasa Oka and Naoki Nakagawa and Takafumi Ito and Shunya Uchida and Kengo Furuichi and Izaya Nakaya and Satoshi Umemura and Keiju Hiromura and Mitsuhiro Yoshimura and Nobuhito Hirawa and Takashi Shigematsu and Masafumi Fukagawa and Makoto Hiramatsu and Yoshio Terada and Osamu Uemura and Tetsuya Kawata and Akira Matsunaga and Aki Kuroki and Yasukiyo Mori and Koji Mitsuiki and Haruyoshi Yoshida",
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TY - JOUR

T1 - Renal disease in the elderly and the very elderly Japanese

T2 - Analysis of the Japan Renal Biopsy Registry (J-RBR)

AU - Yokoyama, Hitoshi

AU - Sugiyama, Hitoshi

AU - Sato, Hiroshi

AU - Taguchi, Takashi

AU - Nagata, Michio

AU - Matsuo, Seiichi

AU - Makino, Hirofumi

AU - Watanabe, Tsuyoshi

AU - Saito, Takao

AU - Kiyohara, Yutaka

AU - Nishi, Shinichi

AU - Iida, Hiroyuki

AU - Morozumi, Kunio

AU - Fukatsu, Atsushi

AU - Sasaki, Tamaki

AU - Tsuruya, Kazuhiko

AU - Kohda, Yukimasa

AU - Higuchi, Makoto

AU - Kiyomoto, Hideyasu

AU - Goto, Shin

AU - Hattori, Motoshi

AU - Hataya, Hiroshi

AU - Kagami, Shoji

AU - Yoshikawa, Norishige

AU - Fukasawa, Yuichiro

AU - Ueda, Yoshihiko

AU - Kitamura, Hiroshi

AU - Shimizu, Akira

AU - Oka, Kazumasa

AU - Nakagawa, Naoki

AU - Ito, Takafumi

AU - Uchida, Shunya

AU - Furuichi, Kengo

AU - Nakaya, Izaya

AU - Umemura, Satoshi

AU - Hiromura, Keiju

AU - Yoshimura, Mitsuhiro

AU - Hirawa, Nobuhito

AU - Shigematsu, Takashi

AU - Fukagawa, Masafumi

AU - Hiramatsu, Makoto

AU - Terada, Yoshio

AU - Uemura, Osamu

AU - Kawata, Tetsuya

AU - Matsunaga, Akira

AU - Kuroki, Aki

AU - Mori, Yasukiyo

AU - Mitsuiki, Koji

AU - Yoshida, Haruyoshi

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Background and objectives: Data regarding renal disease in the elderly (age ≥65 years old) and very elderly (age ≥80 years old) Japanese are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in elderly patients who underwent renal biopsy. Design, setting, participants, and measurements: From July 2007 to November 2011, all of the elderly native renal biopsy patients who had been registered in the Japan Renal Biopsy Registry (J-RBR; 2802 including 1596 males and 1206 females) were identified. Their data were compared with a control group of 7416 patients who ranged in age from 20 to 64 years old and were registered on the J-RBR over the same period. In addition, the clinical and pathological classifications of 276 very elderly patients were also analyzed. Results: The indications for biopsy were nephrotic syndrome (NS) in 36.2 and 50.7 % of the elderly and the very elderly patients, chronic nephritic syndrome in 31.8 and 17.4 %, and acute kidney injury including rapidly progressive glomerulonephritis in 18.6 and 22.5 %, respectively. Primary glomerular disease was the most frequent diagnosis, followed by MPO-ANCA-positive nephritis, IgA nephropathy (IgAN), and diabetic nephropathy. In primary GN including IgAN, membranous nephropathy (MN) was the most frequent histological type, followed by IgAN and minor glomerular abnormalities. A comparison with the control group showed that MN, MPO-ANCA-positive nephritis, and amyloid nephropathy were more common in the elderly (P < 0.001), and IgAN was less common (P < 0.001). As for nephrotic syndrome in the elderly, MN was the most common histological type, followed by minimal change NS, diabetic nephropathy, amyloid nephropathy, and focal segmental glomerulosclerosis. There was a significant discrepancy between the urinary protein/creatinine ratio and daily proteinuria after the 7th decade of life. Conclusions: Renal biopsy is a valuable diagnostic tool, even in elderly and very elderly Japanese patients. In the future, modified clinical guidelines for elderly renal disease should be developed.

AB - Background and objectives: Data regarding renal disease in the elderly (age ≥65 years old) and very elderly (age ≥80 years old) Japanese are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in elderly patients who underwent renal biopsy. Design, setting, participants, and measurements: From July 2007 to November 2011, all of the elderly native renal biopsy patients who had been registered in the Japan Renal Biopsy Registry (J-RBR; 2802 including 1596 males and 1206 females) were identified. Their data were compared with a control group of 7416 patients who ranged in age from 20 to 64 years old and were registered on the J-RBR over the same period. In addition, the clinical and pathological classifications of 276 very elderly patients were also analyzed. Results: The indications for biopsy were nephrotic syndrome (NS) in 36.2 and 50.7 % of the elderly and the very elderly patients, chronic nephritic syndrome in 31.8 and 17.4 %, and acute kidney injury including rapidly progressive glomerulonephritis in 18.6 and 22.5 %, respectively. Primary glomerular disease was the most frequent diagnosis, followed by MPO-ANCA-positive nephritis, IgA nephropathy (IgAN), and diabetic nephropathy. In primary GN including IgAN, membranous nephropathy (MN) was the most frequent histological type, followed by IgAN and minor glomerular abnormalities. A comparison with the control group showed that MN, MPO-ANCA-positive nephritis, and amyloid nephropathy were more common in the elderly (P < 0.001), and IgAN was less common (P < 0.001). As for nephrotic syndrome in the elderly, MN was the most common histological type, followed by minimal change NS, diabetic nephropathy, amyloid nephropathy, and focal segmental glomerulosclerosis. There was a significant discrepancy between the urinary protein/creatinine ratio and daily proteinuria after the 7th decade of life. Conclusions: Renal biopsy is a valuable diagnostic tool, even in elderly and very elderly Japanese patients. In the future, modified clinical guidelines for elderly renal disease should be developed.

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