Evidence-based clinical practice guidelines for IgA nephropathy 2014
Evidence-based clinical practice guidelines for IgA nephropathy 2014
Yukio Yuzawa 0 1 2 3 5 7
Ryohei Yamamoto 0 1 2 3 5 7
Kazuo Takahashi 0 1 2 3 5 7
Ritsuko Katafuchi 0 1 2 3 5 7
Makoto Tomita 0 1 2 3 5 7
Yoshihide Fujigaki 0 1 2 3 5 7
Hiroshi Kitamura 0 1 2 3 5 7
Masashi Goto 0 1 2 3 5 7
Takashi Yasuda 0 1 2 3 5 7
Mitsuhiro Sato 0 1 2 3 5 7
Maki Urushihara 0 1 2 3 5 7
Shuji Kondo 0 1 2 3 5 7
Shoji Kagami 0 1 2 3 5 7
Yoshinari Yasuda 0 1 2 3 5 7
Hiroyuki Komatsu 0 1 2 3 4 5 7
Miki Takahara 0 1 2 3 5 6 7
Yasuaki Harabuchi 0 1 2 3 5 6 7
Kenjiro Kimura 0 1 2 3 5 7
Seiichi Matsuo 0 1 2 3 5 7
Kichijoji Asahi Hospital, Tokyo, Japan
0 Teikyo University School of Medicine , Tokyo , Japan
1 National Fukuoka-Higashi Medical Center , Koga , Japan
2 Osaka University Graduate School of Medicine , Suita , Japan
3 Tokushima University Graduate School , Tokushima , Japan
4 University of Miyazaki Hospital , Miyazaki , Japan
5 Kyoto Medical Center , Kyoto , Japan
6 Asahikawa Medical University , Asahikawa , Japan
7 Chiba East Hospital , Chiba , Japan
The third version, published in 2011, analyzed data from a multicenter study conducted mainly by the Research Group for IgAN in the Progressive Renal Dysfunction Research Group of MHLW to propose a novel prognostic classification (risk stratification for dialysis), adding clinical severity to histological severity. These clinical practice guides present clear prognostic criteria and treatment guidelines according to the criteria. Therefore, these guides have been widely used in clinical practice or pathological diagnosis, and they have contributed to the diagnosis and treatment of IgAN in Japan. Meanwhile, Kidney Disease: Improving Global Outcomes (KDIGO) internationally published the Clinical Practice Guidelines for Glomerulonephritis in 2011. Recommendation grades based on the systematic review of clinical studies and the quality of evidence as a basis for determination of the strength of the recommendations are shown in the KDIGO Clinical Guidelines for Glomerulonephritis. IgAN is described in Chap. 10. However, careful evaluation was required to verify whether the KDIGO Clinical Guidelines for Glomerulonephritis was applicable to the actual clinical situation of IgAN in Japan,
Preface
1. Background of this guideline
Immunoglobulin A (IgA) nephropathy (IgAN) is the most
common primary glomerulonephritis, and patients typically
require dialysis when the disease progresses to end-stage
renal failure. As the incidence of IgAN is high in Asian
populations, including Japanese, establishing a treatment
strategy in Japan is strongly warranted. In 1995, the joint
committee of the Special Study Group of the Progressive
Renal Dysfunction Research Group of the Ministry of
Health Labour and Welfare (MHLW) and the Japanese
Society of Nephrology (JSN) developed the Clinical
Practice Guides for IgAN for the first time. Its second
version was published with a partial amendment in 2002.
In 2011, the Research for Progressive Kidney Diseases of Ministry of
Health and Labour and Welfare (MHLW) and the Japanese Society of
Nephrology (JSN) established the collaborative clinical guidelines
committee, which published JSN and MHLW Evidence-Based
Clinical Practice Guidelines for IgA nephropathy 2014 in Nihon Jinzo
Gakkai Shi, 2015;57(
1
):5–137. This is the English version of that
report, which was uploaded on JSN website on July 27, 2015.
Fujita Health University School of Medicine, Toyoake, Japan
JCHO Sendai Hospital, Sendai, Japan
10 Nagoya University Graduate School of Medicine, Nagoya,
Japan
13 St. Marianna University School of Medicine, Kawasaki,
Japan
because in Japan, IgAN has been detected in routine
checkups in the early stage, prognosis of IgAN has been
classified in many cases according to the third version of
the Clinical Guides for IgAN, and tonsillectomy has been
performed in many cases. Therefore, establishing practice
guidelines for IgAN that are adjusted to the situation in
Japan is warranted. Responding to this need, the
Progressive Renal Dysfunction Research Group of MHLW and
JSN decided to develop the evidence-based Clinical
Guidelines for IgA Nephropathy 2014. Thus, they
established the Clinical Guidelines for IgA Nephropathy 2014
Advisory Committee. Against this background, the Clinical
Guidelines for IgA Nephropathy 2014 was published. It is
the first-ever-published comprehensive guideline only
focusing on IgAN.
2. The intended purpose, anticipated users, and predicted social significance of the guidelines
The purpose of the Clinical Guidelines for IgA Nephropathy
2014 was to define evidence-based clinical guidelines that
reflect the clinical situation of IgAN in Japan. This guideline
is developed to provide answers to clinical questions (CQ)
that nephrologists may encounter in the clinical practice for
the treatment of IgAN. Each answer is shown as a statement,
and recommendation grades based on the evidence-based
levels are noted for each statement in the Treatm (...truncated)