P0396THE NEPHRITIC SYNDROME IN JAPAN AND EUROPE

• Published in: Nephrology, dialysis, transplantation Vol. 35; no. Supplement_3
• Main Authors: Weiner, Maria, Fujimoto, Shouichi, Suzuki, Yusuke, Skrunes, Rannveig, Goritschan, Anna, Crnogorac, Matija, Geddes, Colin C, Turkmen, Kultigin, Galesic, Kresimir, Rosenkranz, Alexander, Kaname, Shinya, Sugiyama, Hitoshi, Segelmark, Mårten
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01-06-2020
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfaa142.P0396

Abstract
Background and Aims
The combination of new onset haematuria, proteinuria and declining GFR, often referred to as the nephritic syndrome, constitute a strong indication for renal biopsy. Several different disease entities can underlie these findings, many of them requiring prompt treatment. Epidemiological studies of glomerular diseases are in general hampered by the strong influence of differences in biopsy practices. However, there is reason to believe that such differences are less pronounced in cases of acute/subacute nephritic syndrome. The aim of the present study is to compare the frequencies of diseases causing the nephritic syndrome in Japan and Europe using data from renal biopsy registries.
Method
Data were retrieved from national or regional renal biopsy registries in Japan, Sweden, Norway, Scotland, Austria, Croatia and Turkey from 2007-01-01 to 2018-12-31. Only patients biopsied due to acute or subacute nephritic syndrome, defined as a combination of new onset haematuria, sub-nephrotic proteinuria and reduced GFR, were included. Demographic, clinical and laboratory data were collected from the time of renal biopsy.
Results
A total number of 2789 patients from Japan and 1202 patients from Europe were included. Among the Japanese patients, 46% were women, median age was 67 years (IQR 54-74) and median creatinine concentration at the time of renal biopsy was 198 µmol/L (IQR 109-343). In Europe, 43% were women, median age was 58 years (IQR 42-70) and median creatinine concentration was 210 µmol/L (IQR 127-390). Figures from the different European countries are presented in Table 1. The most common diagnosis in both Japan and Europe was ANCA-associated nephritis (44% in Japan, 34% in Europe), followed by IgA nephritis (8.5% in Japan, 18.6% in Europe) and acute tubulointerstitial nephritis (6.2% in Japan and 7.1% in Europe).
Conclusion
We describe preliminary data from a large multicenter cohort of patients presenting with the nephritic syndrome. This clinical presentation is most often encountered in the 6th and 7th decade of life and the distribution between men and women is fairly equal. The most common underlying cause of the nephritic syndrome in both Japan and Europe is ANCA-associated nephritis.
Table 1.
Clinical and demographic data in the participating European countries
Norway
Sweden
Scotland
Austria
Croatia
Turkey
No. of patients
353
411
94
182
126
36
Age (years)
57 (39-70)
62 (44-72)
63 (53-75)
50 (38-64)
61 (49-70)
42 (31-54)
Female
40.8%
42.5%
55.3%
46.2%
39.7%
38.9%
Creatinine (µmol/L)
192 (120-334)
202 (133-357)
316 (198-453)
138 (90-263)
511 (332-687)
121 (94-188)
Most common diagnoses1.
ANCA-associated nephritis 32.6%
ANCA-associated nephritis 35.0%
ANCA-associated nephritis 41.5%
ANCA-associated nephritis 25.8%
ANCA-associated nephritis 46.8%
IgA nephritis 36.1%
2.
IgA nephritis 19.3%
IgA nephritis 17.8%
IgA nephritis 18.1%
IgA nephritis 20.3%
Tubulo-interstitial nephritis 13.5%
Acute glomerulo- nephritis 22.2%
3.
Lupus nephritis 7.1%
Tubulo-interstitial nephritis 7.3%
Tubulo-interstitial nephritis 7.4%
Lupus nephritis 19.2%
IgA nephritis 12.7%
Tubulo-interstitial nephritis 11.1%
Data are presented as percentages or as median with interquartile range.