ニッタ　コウサク   NITTA Kousaku   新田　孝作    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
言語種別	英語
発表タイトル	Attribute-Based Medicine for IgAN: A Nationwide Japanese Cohort Reveals Prognostic Interactions
会議名	Kidney Week 2025
主催者	American Society of Nephrology
学会区分	国際学会及び海外の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎Kataoka Hiroshi, Manabe Shun, Moriyama Takahito, Ushio Yusuke, Nitta Kosaku, Hoshino Junichi, Hirano Keita, Matsuzaki Keiichi, Yasuda Takashi, Yasuda Yoshinari, Kawamura Tetsuya, Maruyama Shoichi, Yokoo Takashi, Suzuki Yusuke
発表年月日	2025/11/07
国名	アメリカ合衆国
開催地 （都市, 国名）	Houston, USA
開催期間	2025/11/05～2025/11/09
概要	Background IgA nephropathy (IgAN) is a heterogeneous glomerular disease with variable progression patterns. Attribute-based medicine emphasizes tailoring treatment to individual characteristics. We hypothesized that this approach could clarify residual risks and inform personalized management. Methods This secondary analysis included 996 adults from the Japanese Nationwide Retrospective Cohort Study in IgAN. The primary outcome was kidney replacement therapy or a ≥1.5-fold increase in serum creatinine. Six attributes were assessed: age, sex, BMI, CKD stage, urinary protein excretion (U-Prot), and urine occult blood (U-OB). Cox regression and Kaplan–Meier analyses evaluated main effects and interactions with eight clinical variables (e.g., eGFR, corticosteroid use, hyperuricaemia). Results Over a median 7.0 years, 111 patients (11.1%) reached the primary outcome. Multivariable analysis identified low eGFR (HR=0.87 per 10 mL/min/1.73 m2), high U-Prot (log HR=4.54), and hyperuricaemia (HR=1.64) as risk factors; corticosteroids (HR=0.60) and tonsillectomy (HR=0.44) were protective. Key interactions included: 1. Hyperuricaemia with BMI <22 kg/m2 (HR=3.44, P=0.003), 2. Hypertension with female sex (HR=4.36, P=0.018), 3. The prognostic impact of age and eGFR differed between CKD stage 3 and stages 1–2, indicating a reversal in risk association, 4. Stronger association of U-Prot with outcomes in those with U-OB ≤2+, 5. Corticosteroids improved outcomes in patients with U-Prot ≥1 g/day, while tonsillectomy was most effective in those with U-OB ≥3+. Conclusion Attribute-based analysis uncovered critical risk modifiers and supports individualized treatment strategies in IgAN. This approach enables precision nephrology and may improve kidney outcomes by aligning therapy with patient attributes.