Clinical and Experimental Nephrology

, Volume 21, Issue 4, pp 651–657 | Cite as

High incidence of idiopathic nephrotic syndrome in East Asian children: a nationwide survey in Japan (JP-SHINE study)

  • Kaori Kikunaga
  • Kenji IshikuraEmail author
  • Chikako Terano
  • Mai Sato
  • Fumiyo Komaki
  • Yuko Hamasaki
  • Satoshi Sasaki
  • Kazumoto Iijima
  • Norishige Yoshikawa
  • Koichi Nakanishi
  • Hitoshi Nakazato
  • Takeshi Matsuyama
  • Takashi Ando
  • Shuichi Ito
  • Masataka Honda
  • On behalf of the Japanese Pediatric Survey Holding Information of NEphrotic syndrome (JP-SHINE) study of the Japanese Study Group of Renal Disease in Children
Original article



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.


Children 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

Financial disclosure

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.

Supplementary material

10157_2016_1319_MOESM1_ESM.tif (158 kb)
Supplementary material 1 (TIFF 158 kb)


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Copyright information

© Japanese Society of Nephrology 2016

Authors and Affiliations

  • Kaori Kikunaga
    • 1
  • Kenji Ishikura
    • 1
    • 2
    Email author
  • Chikako Terano
    • 1
  • Mai Sato
    • 2
  • Fumiyo Komaki
    • 3
  • Yuko Hamasaki
    • 4
  • Satoshi Sasaki
    • 5
  • Kazumoto Iijima
    • 6
  • Norishige Yoshikawa
    • 7
  • Koichi Nakanishi
    • 7
  • Hitoshi Nakazato
    • 8
  • Takeshi Matsuyama
    • 9
  • Takashi Ando
    • 10
  • Shuichi Ito
    • 2
    • 11
  • Masataka Honda
    • 1
  • On behalf of the Japanese Pediatric Survey Holding Information of NEphrotic syndrome (JP-SHINE) study of the Japanese Study Group of Renal Disease in Children
  1. 1.Department of NephrologyTokyo Metropolitan Children’s Medical CenterTokyoJapan
  2. 2.Division of Nephrology and RheumatologyNational Center for Child Health and DevelopmentTokyoJapan
  3. 3.Department of Health and Welfare Bureau, Health and Welfare Bureau Health Center of Kawasaki CityKanagawaJapan
  4. 4.Department of Pediatric Nephrology, Faculty of MedicineToho UniversityTokyoJapan
  5. 5.Department of Pediatrics, Graduate School of MedicineHokkaido UniversitySapporoJapan
  6. 6.Department of Pediatrics, Graduate School of MedicineKobe UniversityKobeJapan
  7. 7.Clinical Research CenterWakayama Medical UniversityWakayamaJapan
  8. 8.Department of Pediatrics, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
  9. 9.Department of PediatricsFussa HospitalTokyoJapan
  10. 10.Japan Clinical Research Support UnitTokyoJapan
  11. 11.Department of Pediatrics, Graduate School of MedicineYokohama City UniversityYokohamaJapan

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