Publications by authors named "Katafuchi R"
Article Synopsis
- * Researchers divided 31 FSGS patients into two groups: those with and without cellular lesions (CEL-L) and found differences in the behavior of a protein called β1 integrin (ITGB1).
- * Results showed that higher ITGB1 levels and more significant subendothelial widening were present in the CEL-L(+) group, suggesting that different pathological mechanisms are involved in FSGS depending on the presence of cellular lesions.
Article Synopsis
- * In a study involving 947 children with IgAN, the revised tool outperformed the original in terms of model fit and predictive accuracy for 4-year outcomes, showing enhanced calibration and statistical values.
- * The findings indicated that kidney function (eGFR) trajectories were non-linear, with higher-risk children showing a faster decline, suggesting that the updated prediction should be used for ongoing risk assessment after one or two years following biopsy.
We report a case of IgG4-related disease (IgG4-RD) with marked eosinophilia. A 79-year-old woman was admitted due to diarrhoea and weight loss. Cervical lymphadenopathy, bilateral submandibular glands swelling, anaemia (Hb8.
View Article and Find Full Text PDFBackground: Nephritis is a common manifestation of IgA vasculitis and is morphologically indistinguishable from IgA nephropathy. While MEST-C scores are predictive of kidney outcomes in IgA nephropathy, their value in IgA vasculitis nephritis has not been investigated in large multiethnic cohorts.
Methods: Biopsies from 262 children and 99 adults with IgA vasculitis nephritis ( N =361) from 23 centers in North America, Europe, and Asia were independently scored by three pathologists.
Background: We require a clinicopathological risk stratification method for immunoglobulin A nephropathy (IgAN) to predict kidney outcomes. We examined a renal failure risk group (RF-RG) classification system created following a prior multicentre, retrospective study to determine if RF-RG could predict kidney outcomes.
Methods: We collected data from Japanese patients with IgAN registered between 1 April 2005 and 31 August 2015.
Background: In recent years, many researchers have focused on the use of legacy data, such as pooled analyses that collect and reanalyze data from multiple studies. However, the methodology for the integration of preexisting databases whose data were collected for different purposes has not been established. Previously, we developed a tool to efficiently generate Study Data Tabulation Model (SDTM) data from hypothetical clinical trial data using the Clinical Data Interchange Standards Consortium (CDISC) SDTM.
View Article and Find Full Text PDFBackground: BK polyomavirus-associated nephropathy (BKPyVAN) has become a major cause of kidney dysfunction and graft loss in kidney transplant recipients. On rare occasion, polyomavirus has also been known to affect native kidneys of immunocompromised individuals. Only a small number of opportunistic infections have been reported in the carrier phase of human T-lymphotropic virus type 1 (HTLV-1).
View Article and Find Full Text PDFEfficacy of systemic corticosteroid therapy (CS) for long-term kidney survival in patients with IgA nephropathy (IgAN) is controversial. Therefore, prospective studies evaluating targeted therapies to lymphatic tissues in mucosal immune system responsible for production of nephritogenic IgA have been desired worldwide. Here, we aimed to evaluate the associations of CS and combination therapy of CS and tonsillectomy (CS + Tx) with kidney survival, using database from a nationwide multicenter prospective cohort study on IgAN.
View Article and Find Full Text PDFBackground: Although the number of elderly patients with chronic kidney disease (CKD) has increased, few studies have examined their prognosis.
Methods: The study design was a retrospective cohort study at a single centre. We evaluated 301 patients aged ≥75 years old with CKD stage G3a to G5.
Background: In 2012, we established a CKD network in collaboration with the public health service, primary care physicians, and nephrologists in the Kasuya area. The aim of this study was to clarify if our CKD network was effective in preventing CKD progression.
Methods: 1591 subjects, who had CKD in health checks in 2012 were included in this study.
Article Synopsis
- - In immunoglobulin A nephropathy (IgAN), Cox regression analysis has been used to identify independent factors affecting renal functional decline (RFD), but the relationship between histological features and clinical/treatment variables is unclear, making treatment decisions based on histology uncertain.
- - A study followed 946 Japanese patients with IgAN for an average of 66 months and utilized structural equation modeling (SEM) to analyze how histological variables impact RFD through clinical factors like proteinuria and treatment methods, including steroid therapy and renin-angiotensin system blockers.
- - The results revealed that certain histological features, such as tubular atrophy/interstitial fibrosis, directly accelerate RFD, while others like endocapillary hypercell
Background: Prognosis of nephrotic syndrome has been evaluated based on pathological diagnosis, whereas its clinical course is monitored using objective items and the treatment strategy is largely the same. We examined whether the entire natural history of nephrotic syndrome could be evaluated using objective common clinical items.
Methods: Machine learning clustering was performed on 205 cases from the Japan Nephrotic Syndrome Cohort Study, whose clinical parameters, serum creatinine, serum albumin, dipstick hematuria, and proteinuria were traceable after kidney biopsy at 5 measured points up to 2 years.
Article Synopsis
- Previous studies on serum albumin concentration's effect on proteinuria remission in minimal change disease (MCD) showed mixed results, prompting this study to investigate its impact in a large cohort of 108 adult patients in Japan.
- The study found that 96.3% of patients achieved remission of proteinuria, with lower serum albumin levels and higher estimated glomerular filtration rate (eGFR) linked to earlier remission.
- However, serum albumin levels were not associated with the relapse of proteinuria, indicating that while albumin concentration plays a role in remission timing, it doesn't affect the likelihood of relapse in MCD.
Background: Minimal change disease (MCD) is characterized by a nephrotic syndrome usually steroid-sensitive and a high incidence of relapse of proteinuria. Previous cohort studies have reported conflicting results regarding the association between the time to remission and incidence of relapse.
Methods: This multicenter prospective cohort study included 102 adult patients with steroid-sensitive MCD or focal segmental glomerulosclerosis from a 5-year cohort study of primary nephrotic syndrome, the Japan Nephrotic Syndrome Cohort Study, who achieved remission of proteinuria within 2 months of immunosuppressive therapy (IST).
Article Synopsis
- A study analyzed data from 304 patients with focal segmental glomerulosclerosis (FSGS), looking at how different histological variants impact kidney health over five years.
- Most participants had the "FSGS not otherwise specified" variant, and the overall outcomes showed no major differences between the variants, although 29% experienced significant kidney decline.
- Importantly, achieving proteinuria remission (PR) was linked to better kidney outcomes, suggesting that targeting PR could enhance prognosis regardless of FSGS variant type.
Background: Clinicopathological significance of light chain deposition in IgA nephropathy and the relation of monotypic IgA deposition to bone marrow abnormalities are important issues to be clarified.
Methods: We retrospectively investigated light chain deposition in 526 patients with IgA nephropathy. We divided the patients into 5 groups according to the balance of intensity of both light chain deposition: lambda monotypic, lambda dominant, polytypic, kappa dominant and kappa monotypic.
Background: The correlations between clinical data and pathological findings at the time of renal biopsy were investigated in IgA nephropathy patients.
Methods: 771 patients diagnosed with IgA nephropathy by renal biopsy were enrolled. The correlations between clinical variables including eGFR, daily proteinuria, mean arterial pressure (MAP), serum uric acid (UA) values, and pathological parameters were examined.
Background: On the basis of findings of observational studies and a meta-analysis, proteinuria reduction has been proposed as a surrogate outcome in IgA nephropathy. How long a reduction in proteinuria needs to be maintained to mitigate the long-term risk of disease progression is unknown.
Methods: In this retrospective multiethnic cohort of adult patients with IgA nephropathy, we defined proteinuria remission as a ≥25% reduction in proteinuria from the peak value after biopsy, and an absolute reduction in proteinuria to <1 g/d.
Article Synopsis
- * The study involved analyzing data from groups categorized by age: pediatric, adult, and elderly, revealing that pediatric and elderly patients had a higher prevalence of nephrotic syndrome compared to adults.
- * Additionally, certain clinical factors like higher blood pressure and hematuria were found to distinguish FSGS from MCD, highlighting that primary FSGS patients aged 18-64 had lower rates of nephrotic syndrome than those in other age groups.
Although IgA nephropathy (IgAN) is a common cause of glomerulonephritis in children, the absence of a method to predict disease progression limits personalized risk-based treatment decisions. The adult International IgAN Prediction Tool comprises two validated Cox survival models that predict a 50% decline in estimated glomerular filtration rate (eGFR) or end stage kidney disease (ESKD) using clinical risk factors and Oxford MEST histology scores. Here, we updated the Prediction Tool for use in children using a multiethnic international cohort of 1,060 children with IgAN followed into adulthood.
View Article and Find Full Text PDFBackground: Atypical hemolytic uremic syndrome (aHUS) is a life-threatening disease that leads to end-stage kidney disease if only a poor response to plasma exchanges (PEs) or eculizumab therapy is achieved.
Case Presentation: A 58-year-old Japanese man presented with thrombocytopenia, anemia, and kidney failure requiring dialysis without any underlying disease. A kidney biopsy revealed marked mesangiolysis in all glomeruli, compatible with thrombotic microangiopathy (TMA).
Background: The aim of the present study was to clarify the prevalence of immunosuppressive drug use and outcomes in elderly and non-elderly patients with primary membranous nephropathy (MN) in nationwide real-world practice in Japan.
Patients And Methods: Between 2009 and 2010, 374 patients with primary nephrotic syndrome were enrolled in the cohort study (The Japan Nephrotic Syndrome Cohort Study, JNSCS), including 126 adult patients with MN. Their clinical characteristics were compared with those of nephrotic patients with primary MN registered in a large nationwide registry (The Japan Renal Biopsy Registry, J-RBR).
Immunosuppression in IgA nephropathy (IgAN) should be reserved for patients at high-risk of disease progression, which KDIGO guidelines determine based solely on proteinuria 1g or more/day. To investigate if treatment decisions can be more accurately accomplished using individualized risk from the International IgAN Prediction Tool, we simulated allocation of a hypothetical immunosuppression therapy in an international cohort of adults with IgAN. Two decision rules for treatment were applied based on proteinuria of 1g or more/day or predicted risk from the Prediction Tool above a threshold probability.
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