TY - JOUR
T1 - Predictors of early remission of proteinuria in adult patients with minimal change disease
T2 - a retrospective cohort study
AU - JNSCS Investigators
AU - Yamamoto, Ryohei
AU - Imai, Enyu
AU - Maruyama, Shoichi
AU - Yokoyama, Hitoshi
AU - Sugiyama, Hitoshi
AU - Takeda, Asami
AU - Uchida, Shunya
AU - Tsukamoto, Tatsuo
AU - Tsuruya, Kazuhiko
AU - Akai, Yasuhiro
AU - Nitta, Kosaku
AU - Fukunaga, Megumu
AU - Hayashi, Hiroki
AU - Masutani, Kosuke
AU - Wada, Takashi
AU - Konta, Tsuneo
AU - Katafuchi, Ritsuko
AU - Nishio, Saori
AU - Goto, Shunsuke
AU - Tamai, Hirofumi
AU - Shirasaki, Arimasa
AU - Shoji, Tatsuya
AU - Nagai, Kojiro
AU - Nishino, Tomoya
AU - Yamagata, Kunihiro
AU - Kazama, Junichiro J.
AU - Hiromura, Keiju
AU - Yasuda, Hideo
AU - Mizutani, Makoto
AU - Naruse, Tomohiko
AU - Hiramatsu, Takeyuki
AU - Morozumi, Kunio
AU - Sobajima, Hiroshi
AU - Saka, Yosuke
AU - Ishimura, Eiji
AU - Ichikawa, Daisuke
AU - Shigematsu, Takashi
AU - Sofue, Tadashi
AU - Fujimoto, Shouichi
AU - Ito, Takafumi
AU - Sato, Hiroshi
AU - Narita, Ichiei
AU - Isaka, Yoshitaka
AU - Nishio, Saori
AU - Tsuboi, Naotake
AU - Yuzawa, Yukio
AU - Hasegawa, Midori
AU - Inaguma, Daijo
AU - Koide, Shigehisa
AU - Takahashi, Kazuo
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Previous studies reported conflicting results regarding an association between serum albumin concentration and the cumulative incidence of remission of proteinuria in adult patients with minimal change disease (MCD). The present study aimed to clarify the clinical impact of serum albumin concentration and the cumulative incidence of remission and relapse of proteinuria in 108 adult patients with MCD at 40 hospitals in Japan, who were enrolled in a 5-year prospective cohort study of primary nephrotic syndrome, the Japan Nephrotic Syndrome Cohort Study (JNSCS). The association between serum albumin concentration before initiation of immunosuppressive treatment (IST) and the cumulative incidence of remission and relapse were assessed using multivariable-adjusted Cox proportional hazards models. Remission defined as urinary protein < 0.3 g/day (or g/gCr) was observed in 104 (96.3%) patients. Of 97 patients with remission within 6 month of IST, 42 (43.3%) developed relapse defined as ≥ 1.0 g/day (or g/gCr) or dipstick urinary protein of ≥ 2+. Serum albumin concentration was significantly associated with remission (multivariable-adjusted hazard ratio [95% confidence interval] per 1.0 g/dL, 0.57 [0.37, 0.87]), along with eGFR (per 30 mL/min/1.73 m2: 1.43 [1.08, 1.90]), whereas they were not associated with relapse. A multivariable-adjusted model showed that patients with high eGFR level (≥ 60 mL/min/1.73 m2) and low albumin concentration (≤ 1.5 g/dL) achieved significantly early remission, whereas those with low eGFR (< 60 mL/min/1.73 m2) and high albumin concentration (> 1.5 g/dL) showed significantly slow remission. In conclusion, lower serum albumin concentration and higher eGFR were associated with earlier remission in MCD, but not with relapse.
AB - Previous studies reported conflicting results regarding an association between serum albumin concentration and the cumulative incidence of remission of proteinuria in adult patients with minimal change disease (MCD). The present study aimed to clarify the clinical impact of serum albumin concentration and the cumulative incidence of remission and relapse of proteinuria in 108 adult patients with MCD at 40 hospitals in Japan, who were enrolled in a 5-year prospective cohort study of primary nephrotic syndrome, the Japan Nephrotic Syndrome Cohort Study (JNSCS). The association between serum albumin concentration before initiation of immunosuppressive treatment (IST) and the cumulative incidence of remission and relapse were assessed using multivariable-adjusted Cox proportional hazards models. Remission defined as urinary protein < 0.3 g/day (or g/gCr) was observed in 104 (96.3%) patients. Of 97 patients with remission within 6 month of IST, 42 (43.3%) developed relapse defined as ≥ 1.0 g/day (or g/gCr) or dipstick urinary protein of ≥ 2+. Serum albumin concentration was significantly associated with remission (multivariable-adjusted hazard ratio [95% confidence interval] per 1.0 g/dL, 0.57 [0.37, 0.87]), along with eGFR (per 30 mL/min/1.73 m2: 1.43 [1.08, 1.90]), whereas they were not associated with relapse. A multivariable-adjusted model showed that patients with high eGFR level (≥ 60 mL/min/1.73 m2) and low albumin concentration (≤ 1.5 g/dL) achieved significantly early remission, whereas those with low eGFR (< 60 mL/min/1.73 m2) and high albumin concentration (> 1.5 g/dL) showed significantly slow remission. In conclusion, lower serum albumin concentration and higher eGFR were associated with earlier remission in MCD, but not with relapse.
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U2 - 10.1038/s41598-022-13067-7
DO - 10.1038/s41598-022-13067-7
M3 - Article
C2 - 35697724
AN - SCOPUS:85132081470
SN - 2045-2322
VL - 12
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 9782
ER -