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1,045 results on '"Yoshikawa, Norishige"'

126. Pediatric nephrology

Author

Avner, Ellis D., editor, Harmon, William E., editor, Niaudet, Patrick, editor, Yoshikawa, Norishige, editor, Emma, Francesco, editor, Goldstein, Stuart, editor, Avner, Ellis D., editor, Harmon, William E., editor, Niaudet, Patrick, editor, Yoshikawa, Norishige, editor, Emma, Francesco, editor, and Goldstein, Stuart, editor

Published
2019

139. M-Type Phospholipase A2 Receptor Staining in Children with Idiopathic Membranous Nephropathy: PLA2R Staining in Children with IMN

Author

Inaguma, Yosuke, primary, Shiratori, Atsutoshi, additional, Nakagawa, Taku, additional, Kanda, Kyoko, additional, Yoshida, Makiko, additional, Hara, Shigeo, additional, Kaito, Hiroshi, additional, Nozu, Kandai, additional, Iijima, Kazumoto, additional, Yoshikawa, Norishige, additional, and Tanaka, Ryojiro, additional

Published
2019
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143. Clinicopathological significance of glomerular capillary IgA deposition in childhood IgA nephropathy.

Author

Shima, Yuko, Nakanishi, Koichi, Mukaiyama, Hironobu, Tanaka, Yu, Wada, Takuzo, Tanaka, Ryojiro, Kaito, Hiroshi, Nozu, Kandai, Sako, Mayumi, Iijima, Kazumoto, and Yoshikawa, Norishige

Subjects
SURVIVAL, IMMUNOGLOBULINS, BIOPSY, RETROSPECTIVE studies, DESCRIPTIVE statistics, PROTEINURIA, KAPLAN-Meier estimator, GLOMERULONEPHRITIS, IMMUNOSUPPRESSIVE agents, KIDNEY glomerulus, DISEASE remission
Abstract

Background: IgA nephropathy (IgAN) is characterized by predominant mesangial IgA deposition. Some patients with IgAN demonstrate IgA deposition in glomerular peripheral capillaries (cap-IgA). The clinicopathological significance of cap-IgA remains incompletely investigated in children. Methods: We retrospectively analyzed 503 consecutive cases of biopsy-proven childhood IgAN between July 1976 and June 2013 to compare clinical and pathological features between IgAN patients with and without cap-IgA. Results: Among the 503 patients, 30 (6.0%) had cap-IgA. We found significant differences in proteinuria (2.0 vs. 0.5 g/day/m2, p < 0.0001), time from onset to kidney biopsy (2.2 vs. 8.3 months, p < 0.0001), and rate of proteinuria remission after treatment (23.3% vs. 48.0%, p = 0.007) between both groups. Pathological analysis revealed significant differences in M1 (83.3% vs. 56.0%, p = 0.002), ratio of subendothelial electron dense deposits (EDDs, 58.6% vs. 16.5%, p < 0.0001) and subepithelial EDDs (48.3% vs. 16.5%, p = 0.0001), and glomerular basement membrane (GBM) lysis (58.6% vs. 27.1%, p = 0.0006) between both groups. More than half of cap-IgA patients (17/30, 56.7%), whereas only 26.2% of non-cap-IgA patients (124/473), were treated with immunosuppressive treatments. Six of 30 cases (20%) with cap-IgA reached glomerular filtration rate (GFR) categories G3a–G5 (estimated GFR < 60 ml/min/1.73 m2) at most recent observation (mean observation period: 7.0 ± 4.0 years). According to Kaplan-Meier analysis, patients with cap-IgA had significantly lower kidney survival curves than non-cap-IgA patients (72.8% vs. 97.2% at 10 years, p < 0.0001). Conclusions: Cap-IgA is associated with acute inflammation with GBM changes, resulting in refractory heavier proteinuria. Cap-IgA may represent a poor prognostic factor. [ABSTRACT FROM AUTHOR]

Published
2021
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144. Prognosis and acute complications at the first onset of idiopathic nephrotic syndrome in children: a nationwide survey in Japan (JP-SHINE study).

Author

Sato, Mai, Ishikura, Kenji, Ando, Takashi, Kikunaga, Kaori, Terano, Chikako, Hamada, Riku, Ishimori, Shingo, Hamasaki, Yuko, Araki, Yoshinori, Gotoh, Yoshimitsu, Nakanishi, Koichi, Nakazato, Hitoshi, Matsuyama, Takeshi, Iijima, Kazumoto, Yoshikawa, Norishige, Ito, Shuichi, Honda, Masataka, and Children, the Japanese Pediatric Survey Holding Information of Nephrotic Syndrome (JP-SHINE) study of the Japanese Study Group of Renal Disease in

Abstract

Background Information on the epidemiology of idiopathic nephrotic syndrome (INS) in children, complications of INS and the side effects of steroid therapy is scarce. Methods The Japanese Pediatric Survey Holding Information of Nephrotic Syndrome, a nationwide cohort study, was conducted by the Japanese Study Group of Renal Disease in Children and enrolled 2099 children with newly diagnosed INS between 1 January 2010 and 31 December 2012. We conducted a follow-up study of the complications during the first onset and the patients' prognosis in this cohort. Results We obtained follow-up data on 999 children (672 males) with a median age at onset of 4.5 years [interquartile range (IQR) 2.8–9.4] and a median follow-up period of 4.1 years (IQR 2.5–5.1). At the first onset, 24% of patients experienced severe acute kidney injury (AKI), defined as a serum creatinine increase to a level two or more times the baseline. On logistic regression analysis, age, hematuria, severe hypoalbuminemia (serum albumin <1.0 g/dL) and severe bacterial infection were not independent factors, but female sex {hazard ratio [HR] 1.5 [95% confidence interval (CI) 1.1–1.7]} and hypertension [HR 4.0 (95% CI 2.6–6.0)] were significantly related to AKI. During the observation period, ocular hypertension requiring treatment occurred in 17.4% of patients, among which 0.4% received surgical treatment. Progression to frequently relapsing nephrotic syndrome/steroid-dependent nephrotic syndrome in 3 years was seen in 44.2% of the patients and was shown by the Cox regression analysis to be significantly related to younger age and days until remission at the first episode, but not to sex, hematuria, the minimum serum albumin level or AKI. Two patients died during the observation period. One patient showed progression to end-stage kidney disease. Conclusion Based on the results of a multicenter questionnaire survey, the overall survival and renal survival rates were found to be excellent. However, proper management of complications, particularly in AKI and ocular hypertension, is mandatory. [ABSTRACT FROM AUTHOR]

Published
2021
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147. Study protocol: high-dose mizoribine with prednisolone therapy in short-term relapsing steroid-sensitive nephrotic syndrome to prevent frequent relapse (JSKDC05 trial)

Author

Hama, Taketsugu, Nakanishi, Koichi, Ishikura, Kenji, Ito, Shuichi, Nakamura, Hidefumi, Sako, Mayumi, Saito-Oba, Mari, Nozu, Kandai, Shima, Yuko, Iijima, Kazumoto, Yoshikawa, Norishige, Hama, Taketsugu, Nakanishi, Koichi, Ishikura, Kenji, Ito, Shuichi, Nakamura, Hidefumi, Sako, Mayumi, Saito-Oba, Mari, Nozu, Kandai, Shima, Yuko, Iijima, Kazumoto, and Yoshikawa, Norishige

Abstract

Background: Eighty percent of children with steroid-sensitive nephrotic syndrome (SSNS) relapse within 2 years and 40-50% patients show frequently-relapsing nephrotic syndrome (FRNS). Patients showing a relapse within 6 months after initial remission are at high risk of FRNS. Since frequent prednisolone treatment for FRNS induces severe prednisolone side effects, development of a treatment to prevent patients from shifting to FRNS is desirable. Mizoribine is an immunosuppressive drug with fewer side effects than prednisolone. Recent studies reported the efficacy of high-dose mizoribine in children with FRNS. Methods/design: We conduct a multicenter, open, randomized controlled trial to investigate the efficacy and safety of standard prednisolone plus high-dose mizoribine therapy in children with SSNS showing a relapse within 6 months after an initial remission. Patients are allocated to either standard prednisolone alone treatment group, or standard prednisolone plus high-dose mizoribine group. For the former group, mizoribine is administered at a dose of 10 mg/kg/day once daily and continued for 2 years. The primary endpoint is the duration to frequent relapse. Discussion: The results provide important data on use of high-dose mizoribine to prevent SSNS patients from shifting to FRNS. Since blood concentrations of mizoribine have not been investigated in detail until now, there is a possibility that mizoribine is underestimated in favor of other immunosuppressive drugs. In future, high-dose mizoribine therapy may lead to prevention of relapse in children at high risk of FRNS, and to decreased total dose of prednisolone.

Published
2018

149. A quantitative analysis of the mesangium in children with IgA nephropathy: sequential study

Author

Suzuki, Junko, Yoshikawa, Norishige, and Nakamura, Hajime

Subjects
Kidney glomerulus -- Analysis, IgA glomerulonephritis -- Complications, Health
Abstract

IgA (immunoglobulin A) nephropathy, a disease affecting the glomerulus of the kidneys, has been accepted as a distinct disease entity with variable clinical features and variable outcomes. This disease is characterized by pathological alterations in the mesangium, a central part of the kidney glomerulus between capillaries, resulting in excess cell and tissue growth. A large number of cases, for unknown reasons, progress to kidney (renal) failure. This study examined the relationship between the changes in the mesangium and the clinical and pathological outcome of the patient. The study group consisted of 41 children with IgA nephropathy who had repeat renal biopsies taken during 1981 and 1986 at Kobe University hospital. Children diagnosed with blood in the urine that was considered benign were used as control subjects. Biopsied tissues were examined by light microscopy and immunofluorescence. The IBAS (Zeiss) analysis method was used, which analyzed the image and the area of the mesangial matrix of the specimens by computer. Most of the patients showed an increase or no change in the mesangial matrix, with persistent proteinuria in repeat renal biopsies. This increase appears to be irreversible, and when accompanied by proteinuria, is associated with, and indicative of, a deteriorating clinical condition. The clear-cut value of repeat serial biopsies in children with this illness is demonstrated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

150. Crescentic IgA nephropathy in children.

Author

Shima, Yuko, Nakanishi, Koichi, Hama, Taketsugu, Mukaiyama, Hironobu, Sato, Masashi, Tanaka, Yu, Tanaka, Ryojiro, Kaito, Hiroshi, Nozu, Kandai, Sako, Mayumi, Iijima, Kazumoto, and Yoshikawa, Norishige

Subjects
CHRONIC kidney failure, GLOMERULAR filtration rate, GLOMERULONEPHRITIS, HEMATURIA, IMMUNOSUPPRESSIVE agents, MEDICAL screening, PROTEINURIA, SURVIVAL analysis (Biometry), SYMPTOMS, FIBROSIS, RETROSPECTIVE studies, ATROPHY, KAPLAN-Meier estimator, PREDNISOLONE, CHILDREN
Abstract

Objectives: Crescentic IgA nephropathy (C-IgAN) is defined as IgAN with more than 50% of glomeruli showing crescents. C-IgAN in children is rare; we investigate in detail for the first time. Methods: We retrospectively analyzed the 515 consecutive children who were newly diagnosed with biopsy-proven IgAN between June 1976 and May 2010. We compared clinical and pathological findings between C-IgAN and non-C-IgAN. Results: Among 515 cases of childhood IgAN, 25 children (4.9%) had C-IgAN. Of these 25, 16 children (64%) were referred to hospitals by annual school screening. Clinical findings showed significant differences in gross hematuria (76 vs. 50%, p =.03), excretion of proteinuria (1.9 vs. 0.5 g/day/m2, p <.0001), eGFR (102 vs. 108 ml/min/1.73 m2, p =.03), and duration from onset to renal biopsy (4.0 vs. 8.0 months, p =.04) between groups. Pathological findings showed significant differences in M1 (88 vs. 55%, p =.02), E1 (83 vs. 53%, p =.008), and presence of tubular atrophy/interstitial fibrosis (88 vs. 53%, p <.0001) between groups. The 16 children with C-IgAN were treated with prednisolone and immunosuppressant. Four cases (16%) reached chronic renal failure (eGFR < 60) at the latest observation (mean observation period: 6.0 ± 3.6 years). Patients with C-IgAN had significantly lower renal survival curve than non-C-IgAN patients according to Kaplan-Meier analysis (77.1% vs. 92.6% at 13 years, p <.0001). Compared with previous reports, however, they had better renal outcome. Conclusions: We confirmed the importance of school screening to find C-IgAN. Although most crescents (mean: 98.1%) of C-IgAN were cellular/fibrocellular, and acute lesions were well modified with combination therapy, the presence of tubular atrophy in C-IgAN may be the reason for poorer prognosis. [ABSTRACT FROM AUTHOR]

Published
2020
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