Evidence-based clinical practice guidelines for IgA nephropathy 2014

Clinical and Experimental Nephrology, Apr 2016

Yukio Yuzawa, Ryohei Yamamoto, Kazuo Takahashi, Ritsuko Katafuchi, Makoto Tomita, Yoshihide Fujigaki, Hiroshi Kitamura, Masashi Goto, Takashi Yasuda, Mitsuhiro Sato, et al.

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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)


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Yukio Yuzawa, Ryohei Yamamoto, Kazuo Takahashi, Ritsuko Katafuchi, Makoto Tomita, Yoshihide Fujigaki, Hiroshi Kitamura, Masashi Goto, Takashi Yasuda, Mitsuhiro Sato, Maki Urushihara, Shuji Kondo, Shoji Kagami, Yoshinari Yasuda, Hiroyuki Komatsu, Miki Takahara, Yasuaki Harabuchi, Kenjiro Kimura, Seiichi Matsuo. Evidence-based clinical practice guidelines for IgA nephropathy 2014, Clinical and Experimental Nephrology, 2016, pp. 511-535, Volume 20, Issue 4, DOI: 10.1007/s10157-015-1223-y