High incidence of idiopathic nephrotic syndrome in East Asian children: a nationwide survey in Japan (JP-SHINE study)
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Little is known regarding the epidemiology of idiopathic nephrotic syndrome (INS) in East Asia. Previous studies have suggested higher incidence of INS in Asian children, though decreasing trend of its incidence has also been shown.
We conducted a nationwide study of Japanese children aged 6 months to 15 years with INS. Children who were newly diagnosed with INS between 1 January 2010 and 31 December 2012 were eligible. Children with congenital nephrotic syndrome or nephrotic syndrome secondary to nephritis were excluded.
A total of 2099 children were initially diagnosed with INS and were followed for up to 4 years. The estimated incidence of INS was 6.49 cases/100,000 children per year, without clear correlation with geographical region. The male:female ratio was 1.9 and approximately 50 % of children were <5 years old at diagnosis. During the 1–4 years follow-up, 32.7 % developed frequently relapsing nephrotic syndrome and steroid-dependent nephrotic syndrome.
Based on our nationwide survey, the incidence of INS in Japanese children is approximately 3–4 times higher than that in Caucasians. However, the male:female ratio and the age at onset were similar to those in previous studies. We are now planning a prospective cohort study to examine the course of INS in Japan.
KeywordsChildren Idiopathic nephrotic syndrome Asia Nationwide survey Epidemiological study Incidence
Information on all hospitals, institutions, and pediatricians was extracted from the “Medical database” supported by Nihon Ultmarc Inc. We thank Nicholas Smith, PhD, of Edanz Group Ltd., for providing language editorial support in the preparation of the manuscript. We also thank everyone who contributed data to this study, including all of the anonymous participants.
Compliance with ethical standards
This study was supported by Asahi Kasei Pharma Corporation, Astellas Pharma, Fuso Pharmaceutical Industries, Ltd, JMS Co., Ltd., Novartis Pharma K.K., and Zenyaku Kogyo Co., Ltd.
Conflict of interest
Norishige Yoshikawa has received research funding from Novartis Pharma K.K. and Asahi Kasei Pharma Corporation. Kazumoto Iijima has received research funding from Daiichi Sankyo, Co., Ltd., Clio, Co., Ltd., Sysmex Corporation, and manuscript fees from Chugai Pharmaceutical Co., Ltd. Yuko Hamasaki belongs to an endowed department sponsored by Asahi Kasei Pharma Corporation, Novartis Pharma K.K., Chugai Pharmaceutical Co., and Astellas Pharma.
The present study was conducted in accordance with the ethical principles set out in the Declarations of Helsinki, and with the ethical guidelines for epidemiological studies issued by the Ministry of Health, Labour and Welfare in Japan. The study was approved by a central ethics board (National Center for Child Health and Development; approval number 702) before commencing the study. Because all data were reported in a retrospective manner using patient charts, informed consent was not obtained in accordance with the above guidelines.
- 4.Pravitsitthikul N, Willis NS, Hodson EM, Craig JC. Non-corticosteroid immunosuppressive medications for steroid-sensitive nephrotic syndrome in children. Cochrane Database Syst Rev. 2013;10:CD002290.Google Scholar
- 14.Ishikura K, Matsumoto S, Sako M, Tsuruga K, Nakanishi K, Kamei K, Saito H, Fujinaga S, Hamasaki Y, Chikamoto H, Ohtsuka Y, Komatsu Y, Ohta T, Nagai T, Kaito H, Kondo S, Ikezumi Y, Tanaka S, Kaku Y, Iijima K. Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2013: medical therapy. Clin Exp Nephrol. 2015;19:6–33.CrossRefPubMedGoogle Scholar
- 15.Kaku Y, Ohtsuka Y, Komatsu Y, Ohta T, Nagai T, Kaito H, Kondo S, Ikezumi Y, Tanaka S, Matsumoto S, Sako M, Tsuruga K, Nakanishi K, Kamei K, Saito H, Fujinaga S, Hamasaki Y, Chikamoto H, Ishikura K, Iijima K. Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2013: general therapy. Clin Exp Nephrol. 2015;19:34–53.CrossRefPubMedGoogle Scholar
- 20.Yoshikawa N, Nakanishi K, Sako M, Oba MS, Mori R, Ota E, Ishikura K, Hataya H, Honda M, Ito S, Shima Y, Kaito H, Nozu K, Nakamura H, Igarashi T, Ohashi Y, Iijima K. A multicenter randomized trial indicates initial prednisolone treatment for childhood nephrotic syndrome for 2 months is not inferior to six-month treatment. Kidney Int. 2015;87:225–32.CrossRefPubMedGoogle Scholar
- 22.Sinha A, Saha A, Kumar M, Sharma S, Afzal K, Mehta A, Kalaivani M, Hari P, Bagga A. Extending initial prednisolone treatment in a randomized control trial from 3 to 6 months did not significantly influence the course of illness in children with steroid-sensitive nephrotic syndrome. Kidney Int. 2015;87:217–24.CrossRefPubMedGoogle Scholar