カタオカ　ヒロシ   Kataoka Hiroshi   片岡　浩史    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	High uric acid level is a risk factor for progression of IgA nephropathy with chronic kidney disease stage G3a.
掲載誌名	正式名：Journal of nephrology 略　 称：J Nephrol ISSNコード：1724-6059(Electronic)1121-8428(Linking)
巻・号・頁	28(4),pp.451-6
著者・共著者	Moriyama Takahito†, Itabashi Mitsuyo, Takei Takashi, Kataoka Hiroshi, Sato Masayo, Shimizu Ari, Iwabuchi Yuko, Nishida Miki, Uchida Keiko, Nitta Kosaku
発行年月	2015/08
概要	BACKGROUND:High uric acid level is a known risk factor for deterioration of renal function in chronic kidney disease (CKD), but its influence on the progression of IgA nephropathy (IgAN) remains unclear.METHODS:Adult IgAN patients (n = 611) were classified according to CKD stage. Renal survival rates and clinical and histological findings were compared between patients with high (H-UA) and normal (N-UA) uric acid levels in different CKD stages.RESULTS:The proportion of patients with H-UA increased significantly with increasing CKD stage (stage G1, 12.3%; stage G2, 19.0%; stage G3a, 43.7%; stage G3b-4, 69.0%; PRESULTS:<RESULTS:0.001). The 30-year renal survival rate was similar in patients with H-UA and N-UA in CKD stages G1, G2, and G3b-4, but was significantly lower in patients with H-UA than with N-UA in CKD stage G3a (24.7 vs. 51.9%; P = 0.0205). The clinical findings were similar in patients with H-UA and N-UA, but the interval from onset to biopsy differed between groups. The proportion of patients with global sclerosis was significantly higher in patients with H-UA than with N-UA in CKD stage G3a (33.3 vs. 11.4%; P = 0.0005), but the Oxford classifications were similRESULTS:ar between groups. Multivariate Cox regression analysis identified H-UA (HR 1.36, 95% CI 1.07-1.72, P = 0.011) and a large amount of proteinuria (HR 1.38, 95% CI 1.09-1.74, P = 0.0084) as independent predictors of end-stage renal disease.CONCLUSIONS:H-UA induced global glomerular sclerosis and accelerated the progression of IgAN in CKD stage G3a.
DOI	10.1007/s40620-014-0154-0
文献番号	25355499