Renal pathology in adult and paediatric population of Japan: review of the Japan renal biopsy registry database from 2007 to 2017

doi:10.1007/s40620-023-01687-9

Review

. 2023 Nov;36(8):2257-2267.

doi: 10.1007/s40620-023-01687-9. Epub 2023 Aug 19.

Renal pathology in adult and paediatric population of Japan: review of the Japan renal biopsy registry database from 2007 to 2017

Kazunori Goto¹, Takahiro Imaizumi^{1

2}, Riku Hamada³, Kenji Ishikura⁴, Tomoki Kosugi¹, Ichiei Narita⁵, Hitoshi Sugiyama^{6

7}, Akira Shimizu⁸, Hitoshi Yokoyama⁹, Hiroshi Sato¹⁰, Shoichi Mauryama¹¹

Affiliations

¹ Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
² Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Aichi, Japan.
³ Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
⁴ Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
⁵ Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
⁶ Department of Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
⁷ Department of Medical Care Work, Kawasaki College of Allied Health Professions, Okayama, Japan.
⁸ Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan.
⁹ Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan.
¹⁰ JR Sendai Hospital, Miyagi, Japan.
¹¹ Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. marus@med.nagoya-u.ac.jp.

PMID: 37597092
PMCID: PMC10638177
DOI: 10.1007/s40620-023-01687-9

Review

Renal pathology in adult and paediatric population of Japan: review of the Japan renal biopsy registry database from 2007 to 2017

Kazunori Goto et al. J Nephrol. 2023 Nov.

. 2023 Nov;36(8):2257-2267.

doi: 10.1007/s40620-023-01687-9. Epub 2023 Aug 19.

Authors

Affiliations

¹ Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
² Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Aichi, Japan.
³ Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
⁴ Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
⁵ Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
⁶ Department of Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
⁷ Department of Medical Care Work, Kawasaki College of Allied Health Professions, Okayama, Japan.
⁸ Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan.
⁹ Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan.
¹⁰ JR Sendai Hospital, Miyagi, Japan.
¹¹ Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. marus@med.nagoya-u.ac.jp.

PMID: 37597092
PMCID: PMC10638177
DOI: 10.1007/s40620-023-01687-9

Abstract

Background: The Japan Renal Biopsy Registry (J-RBR), a nationwide, web-based, registry system, started in 2007. This study aimed to summarise the epidemiology of biopsy-diagnosed kidney disease in Japan over 10 years.

Methods: We analysed the J-RBR database, from 2007 to 2017. Patients' clinical data collected at the time of biopsy and histopathological diagnoses were used for epidemiological and clinicopathologic analyses.

Results: The predominant renal biopsy diagnoses were immunoglobulin A nephropathy (39.2%), lupus nephritis (6.5%) and minimal change disease (6.0%) in younger adults (19-64 years), and membranous nephropathy (17.4%), antineutrophil cytoplasmic antibody-associated vasculitis or anti-glomerular basement membrane glomerulonephritis (13.0%), and immunoglobulin A nephropathy (12.5%) in older adults (≥ 65 years). The percentages of patients diagnosed with membranoproliferative glomerulonephritis and immunoglobulin A nephropathy decreased, whereas those with immunoglobulin A vasculitis and diabetic nephropathy increased over the decade. In paediatric patients (< 19 years), immunoglobulin A nephropathy (36.1%), minimal change disease (17.6%), and immunoglobulin A vasculitis (8.6%) were the predominant diagnoses. The percentage of patients diagnosed with immunoglobulin A vasculitis increased over the decade. Based on the sex distribution, minimal change disease and membranous nephropathy were predominant in men aged < 20 and > 40 years, respectively, whereas immunoglobulin A vasculitis and antineutrophil cytoplasmic antibody-associated vasculitis or anti-glomerular basement membrane glomerulonephritis were predominant in women in their 20s and 30s and aged < 50 years, respectively. Immunoglobulin A nephropathy was predominant in men at most ages and in women in their 20s to 40s.

Conclusions: This study describes the distribution and changes in kidney biopsy diagnoses over 10 years in Japan and paves the way for future research on kidney diseases in adults and children.

Keywords: Disease aetiology; Japan renal biopsy registry; Kidney biopsy; Renal pathology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Fig. 1**
The proportion of females for each diagnosis. The horizontal bars show standard deviation. *MCD* minimal change disease, *FSGS* focal segmental glomerulosclerosis, MN membranous nephropathy, *MPGN* membranoproliferative glomerulonephritis, *IgAN* IgA nephropathy, *IgAVas* IgA vasculitis, *AAV* antineutrophil cytoplasmic antibody-associated vasculitis, *anti-GBMGN* anti-glomerular basement membrane glomerulonephritis, LN lupus nephritis, *DMN* diabetic nephropathy, *NSc* nephrosclerosis, *ATN* acute tubular necrosis, *TIN* tubulointerstitial nephritis, *ALPO* Alport syndrome, *IRGN* infection-related glomerulonephritis, *TMA* thrombotic microangiopathy, *TBMD* thin basement membrane disease, *AMYL* amyloidosis

**Fig. 2**
The frequency of diagnoses with nephrotic syndrome for each 10-year age group. A The number and B percentage of diagnoses are shown. Data for each panel are shown in Supplementary Table 5

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References

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1. Yokoyama H, Sugiyama H, Sato H, Taguchi T, Nagata M, Matsuo S, Makino H, Watanabe T, Saito T, Kiyohara Y, Nishi S, Iida H, Morozumi K, Fukatsu A, Sasaki T, Tsuruya K, Kohda Y, Higuchi M, Kiyomoto H, Goto S, Hattori M, Hataya H, Kagami S, Yoshikawa N, Fukasawa Y, Ueda Y, Kitamura H, Shimizu A, Oka K, Nakagawa N, Ito T, Uchida S, Furuichi K, Nakaya I, Umemura S, Hiromura K, Yoshimura M, Hirawa N, Shigematsu T, Fukagawa M, Hiramatsu M, Terada Y, Uemura O, Kawata T, Matsunaga A, Kuroki A, Mori Y, Mitsuiki K, Yoshida H, Committee for the Standardization of Renal Pathological Diagnosis and for Renal Biopsy and Disease Registry of the Japanese Society of Nephrology, and the Progressive Renal Disease Research of the Ministry of Health, Labour and Welfare of Japan Renal disease in the elderly and the very elderly Japanese: analysis of the Japan renal biopsy registry (J-RBR) Clin Exp Nephrol. 2012;16:903–920. doi: 10.1007/s10157-012-0673-8. - DOI - PubMed
1. Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Kawamura T, Takeda T, Hataya H, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Shimizu A, Kitamura H, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Nagata M, Taguchi T, Makino H, Committee for Standardization of Renal Pathological Diagnosis, Committee for Kidney Disease Registry, Japanese Society of Nephrology Japan renal biopsy registry and Japan kidney disease registry: committee report for 2009 and 2010. Clin Exp Nephrol. 2013;17:155–173. doi: 10.1007/s10157-012-0746-8. - DOI - PubMed

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[1] O’Shaughnessy MM, Hogan SL, Thompson BD, Coppo R, Fogo AB, Jennette JC. Glomerular disease frequencies by race, sex and region: results from the International kidney biopsy survey. Nephrol Dial Transplant. 2018;33:661–669. doi: 10.1093/ndt/gfx189. - DOI - PMC - PubMed

[2] O’Shaughnessy MM, Hogan SL, Thompson BD, Coppo R, Fogo AB, Jennette JC. Glomerular disease frequencies by race, sex and region: results from the International kidney biopsy survey. Nephrol Dial Transplant. 2018;33:661–669. doi: 10.1093/ndt/gfx189. - DOI - PMC - PubMed

[3] Hamano T, Imaizumi T, Hasegawa T, Fujii N, Komaba H, Ando M, Nangaku M, Nitta K, Hirakata H, Isaka Y, Wada T, Maruyama S, Fukagawa M. Biopsy-proven CKD etiology and outcomes: chronic kidney disease Japan Cohort (CKD-JAC) study. Nephrol Dial Transplant. 2022 doi: 10.1093/ndt/gfac134. - DOI - PMC - PubMed

[4] Hamano T, Imaizumi T, Hasegawa T, Fujii N, Komaba H, Ando M, Nangaku M, Nitta K, Hirakata H, Isaka Y, Wada T, Maruyama S, Fukagawa M. Biopsy-proven CKD etiology and outcomes: chronic kidney disease Japan Cohort (CKD-JAC) study. Nephrol Dial Transplant. 2022 doi: 10.1093/ndt/gfac134. - DOI - PMC - PubMed

[5] Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Nagata M, Kawamura T, Honda M, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Taguchi T, Makino H, Committee for Standardization of Renal Pathological Diagnosis and Working Group for Renal Biopsy Database, Japanese Society of Nephrology, Tokyo, Japan Japan renal biopsy registry: the first nationwide, web-based, and prospective registry system of renal biopsies in Japan. Clin Exp Nephrol. 2011;15:493–503. doi: 10.1007/s10157-011-0430-4. - DOI - PubMed

[6] Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Nagata M, Kawamura T, Honda M, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Taguchi T, Makino H, Committee for Standardization of Renal Pathological Diagnosis and Working Group for Renal Biopsy Database, Japanese Society of Nephrology, Tokyo, Japan Japan renal biopsy registry: the first nationwide, web-based, and prospective registry system of renal biopsies in Japan. Clin Exp Nephrol. 2011;15:493–503. doi: 10.1007/s10157-011-0430-4. - DOI - PubMed

[7] Yokoyama H, Sugiyama H, Sato H, Taguchi T, Nagata M, Matsuo S, Makino H, Watanabe T, Saito T, Kiyohara Y, Nishi S, Iida H, Morozumi K, Fukatsu A, Sasaki T, Tsuruya K, Kohda Y, Higuchi M, Kiyomoto H, Goto S, Hattori M, Hataya H, Kagami S, Yoshikawa N, Fukasawa Y, Ueda Y, Kitamura H, Shimizu A, Oka K, Nakagawa N, Ito T, Uchida S, Furuichi K, Nakaya I, Umemura S, Hiromura K, Yoshimura M, Hirawa N, Shigematsu T, Fukagawa M, Hiramatsu M, Terada Y, Uemura O, Kawata T, Matsunaga A, Kuroki A, Mori Y, Mitsuiki K, Yoshida H, Committee for the Standardization of Renal Pathological Diagnosis and for Renal Biopsy and Disease Registry of the Japanese Society of Nephrology, and the Progressive Renal Disease Research of the Ministry of Health, Labour and Welfare of Japan Renal disease in the elderly and the very elderly Japanese: analysis of the Japan renal biopsy registry (J-RBR) Clin Exp Nephrol. 2012;16:903–920. doi: 10.1007/s10157-012-0673-8. - DOI - PubMed

[8] Yokoyama H, Sugiyama H, Sato H, Taguchi T, Nagata M, Matsuo S, Makino H, Watanabe T, Saito T, Kiyohara Y, Nishi S, Iida H, Morozumi K, Fukatsu A, Sasaki T, Tsuruya K, Kohda Y, Higuchi M, Kiyomoto H, Goto S, Hattori M, Hataya H, Kagami S, Yoshikawa N, Fukasawa Y, Ueda Y, Kitamura H, Shimizu A, Oka K, Nakagawa N, Ito T, Uchida S, Furuichi K, Nakaya I, Umemura S, Hiromura K, Yoshimura M, Hirawa N, Shigematsu T, Fukagawa M, Hiramatsu M, Terada Y, Uemura O, Kawata T, Matsunaga A, Kuroki A, Mori Y, Mitsuiki K, Yoshida H, Committee for the Standardization of Renal Pathological Diagnosis and for Renal Biopsy and Disease Registry of the Japanese Society of Nephrology, and the Progressive Renal Disease Research of the Ministry of Health, Labour and Welfare of Japan Renal disease in the elderly and the very elderly Japanese: analysis of the Japan renal biopsy registry (J-RBR) Clin Exp Nephrol. 2012;16:903–920. doi: 10.1007/s10157-012-0673-8. - DOI - PubMed

[9] Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Kawamura T, Takeda T, Hataya H, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Shimizu A, Kitamura H, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Nagata M, Taguchi T, Makino H, Committee for Standardization of Renal Pathological Diagnosis, Committee for Kidney Disease Registry, Japanese Society of Nephrology Japan renal biopsy registry and Japan kidney disease registry: committee report for 2009 and 2010. Clin Exp Nephrol. 2013;17:155–173. doi: 10.1007/s10157-012-0746-8. - DOI - PubMed

[10] Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Kawamura T, Takeda T, Hataya H, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Shimizu A, Kitamura H, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Nagata M, Taguchi T, Makino H, Committee for Standardization of Renal Pathological Diagnosis, Committee for Kidney Disease Registry, Japanese Society of Nephrology Japan renal biopsy registry and Japan kidney disease registry: committee report for 2009 and 2010. Clin Exp Nephrol. 2013;17:155–173. doi: 10.1007/s10157-012-0746-8. - DOI - PubMed

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Renal pathology in adult and paediatric population of Japan: review of the Japan renal biopsy registry database from 2007 to 2017

Affiliations

Renal pathology in adult and paediatric population of Japan: review of the Japan renal biopsy registry database from 2007 to 2017

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Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

Figures

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