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Relapse and its remission in Japanese patients with idiopathic membranous nephropathy

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Abstract

Background

The prognosis in patients with idiopathic membranous nephropathy (IMN) is diverse. However, the prognosis after relapse and factors affecting relapse remain unclear.

Methods

A total of 146 Japanese patients with IMN who had been followed up for at least 3 years, or until end-stage renal failure or death were enrolled in this retrospective study. The initial clinicopathological factors were examined between the patients with and without relapse. The patients were assigned to two groups based on the electron microscopic findings: homogeneous type with synchronous electron-dense deposits and heterogeneous type with various phases of dense deposits.

Results

A total of 105 of the 146 patients (72 %) achieved complete remission (CR) or incomplete remission (ICR) I after initial treatment. Twenty-six of the 105 patients relapsed after CR or ICR I (25 %). There were no differences in initial clinical findings or data between the patients with and without relapse, except for the higher degree of proteinuria at onset in patients with relapse. The relapse rate of the heterogeneous group (43 %) was higher than that in the homogeneous group (20 %). There were no significant associations between relapse rate and immunosuppressive therapy at onset. Eleven of 26 patients showing relapse (42 %) achieved CR or ICR I, which was lower than the rate for patients with initial remission.

Conclusion

Our results suggest that patients with relapse achieved CR or ICR I and that electron microscopic findings demonstrating heterogeneous type indicated susceptibility to relapse.

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Acknowledgments

This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Rare and Intractable Disease, from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

The authors have declared that no Conflict of interest exists.

Author information

Authors and Affiliations

  1. Division of Nephrology, Kanazawa University Hospital, Kanazawa, Japan

    Shinji Kitajima, Kengo Furuichi, Norihiko Sakai, Akihiro Sagara, Yasuyuki Shinozaki, Tadashi Toyama, Yasunori Iwata, Miho Shimizu & Takashi Wada

  2. Division of Nephrology, Kanazawa Medical University School of Medicine, Kanazawa, Japan

    Hitoshi Yokoyama

  3. Department of Disease Control and Homeostasis, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan

    Shuichi Kaneko

  4. Department of Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan

    Takashi Wada

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  1. Shinji Kitajima
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  2. Kengo Furuichi
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  3. Norihiko Sakai
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  4. Akihiro Sagara
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  5. Yasuyuki Shinozaki
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  9. Hitoshi Yokoyama
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  10. Shuichi Kaneko
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  11. Takashi Wada
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Corresponding author

Correspondence to Takashi Wada.

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Kitajima, S., Furuichi, K., Sakai, N. et al. Relapse and its remission in Japanese patients with idiopathic membranous nephropathy. Clin Exp Nephrol 19, 278–283 (2015). https://doi.org/10.1007/s10157-014-0987-9

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  • DOI: https://doi.org/10.1007/s10157-014-0987-9

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