Clinical and histological features in pediatric and adolescent/young adult patients with renal disease: a cross-sectional analysis of the Japan Renal Biopsy Registry (J-RBR).


Journal

Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 28 12 2020
accepted: 12 05 2021
pubmed: 29 5 2021
medline: 12 1 2022
entrez: 28 5 2021
Statut: ppublish

Résumé

Only a few studies have investigated epidemiological and clinicopathological information regarding pediatric and adolescent and young adult (AYA) patients with renal disease. The purpose of this study was to clarify the differences and relationship of clinicopathological findings between pediatric and AYA patients using the Japan Renal Biopsy Registry (J-RBR). This cross-sectional study analyzed data from patients registered in the J-RBR between 2007 and 2017. Clinicopathological findings at diagnosis were analyzed for 3,463 pediatric (age < 15 years) and 6,532 AYA (age 15-30 years) patients. Although chronic nephritic syndrome was the most common clinical diagnosis at age > 5 years, nephrotic syndrome was the most frequent diagnosis at age < 4 years. The most common pathological diagnosis as classified by pathogenesis in pediatric patients was primary glomerular disease (except IgA nephropathy), whereas IgA nephropathy was increased in AYA patients. Mesangial proliferative glomerulonephritis was the most common pathological diagnosis as classified by histopathology in both pediatric and AYA patients. Minor glomerular abnormalities were the most frequent histopathologic diagnoses of nephrotic syndrome in childhood, but their frequency decreased with age. To the best of our knowledge, this is the first report of clinicopathological features of pediatric and AYA patients in a large nationwide registry of renal biopsy. There were differences of clinical, pathological and histopathologic findings between pediatric and AYA patients.

Sections du résumé

BACKGROUND BACKGROUND
Only a few studies have investigated epidemiological and clinicopathological information regarding pediatric and adolescent and young adult (AYA) patients with renal disease. The purpose of this study was to clarify the differences and relationship of clinicopathological findings between pediatric and AYA patients using the Japan Renal Biopsy Registry (J-RBR).
METHODS METHODS
This cross-sectional study analyzed data from patients registered in the J-RBR between 2007 and 2017. Clinicopathological findings at diagnosis were analyzed for 3,463 pediatric (age < 15 years) and 6,532 AYA (age 15-30 years) patients.
RESULTS RESULTS
Although chronic nephritic syndrome was the most common clinical diagnosis at age > 5 years, nephrotic syndrome was the most frequent diagnosis at age < 4 years. The most common pathological diagnosis as classified by pathogenesis in pediatric patients was primary glomerular disease (except IgA nephropathy), whereas IgA nephropathy was increased in AYA patients. Mesangial proliferative glomerulonephritis was the most common pathological diagnosis as classified by histopathology in both pediatric and AYA patients. Minor glomerular abnormalities were the most frequent histopathologic diagnoses of nephrotic syndrome in childhood, but their frequency decreased with age.
CONCLUSION CONCLUSIONS
To the best of our knowledge, this is the first report of clinicopathological features of pediatric and AYA patients in a large nationwide registry of renal biopsy. There were differences of clinical, pathological and histopathologic findings between pediatric and AYA patients.

Identifiants

pubmed: 34047871
doi: 10.1007/s10157-021-02077-w
pii: 10.1007/s10157-021-02077-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1018-1026

Investigateurs

Naoyuki Hasebe (N)
Naoki Nakagawa (N)
Sekiya Shibazaki (S)
Tomotsune Miyamoto (T)
Masanori Ito (M)
Saori Nishio (S)
Daigo Nakazawa (D)
Takayuki Okamoto (T)
Yasuyuki Sato (Y)
Akira Suzuki (A)
Norihito Moniwa (N)
Marenao Tanaka (M)
Yuichiro Fukasawa (Y)
Hideki Takizawa (H)
Jun Soma (J)
Izaya Nakaya (I)
Junichiro James Kazama (JJ)
Kennichi Tanaka (K)
Mizuko Tanaka (M)
Toshinobu Sato (T)
Satoru Sanada (S)
Hideaki Hashimoto (H)
Mariko Miyazaki (M)
Tasuku Nagasawa (T)
Koji Okamoto (K)
Tsuneo Konta (T)
Kazunobu Ichikawa (K)
Daisuke Ogino (D)
Hiroshi Kitamura (H)
Toshiyuki Imasawa (T)
Chieko Matsumura (C)
Naotake Akutsu (N)
Koichi Kamura (K)
Tetsuro Takeda (T)
Toshihiko Ishimitsu (T)
Keiju Hiromura (K)
Yoriaki Kaneko (Y)
Hidekazu Ikeuchi (H)
Toru Sakairi (T)
Daisuke Nagata (D)
Osamu Saito (O)
Tetsu Akimoto (T)
Akito Maeshima (A)
Takashi Yokoo (T)
Nobuo Tsuboi (N)
Kentaro Koike (K)
Yudo Tanno (Y)
Shinya Yokote (S)
Yoichi Miyazaki (Y)
Hiroyuki Ueda (H)
Masahiro Okabe (M)
Mai Tanaka (M)
Masato Ikeda (M)
Akihiro Shimizu (A)
Yusuke Suzuki (Y)
Tomohito Goda (T)
Masao Kihara (M)
Miyuki Takagi (M)
Masahiro Ishikawa (M)
Shinya Kaname (S)
Miho Karube (M)
Kazuhito Fukuoka (K)
Takahisa Kawakami (T)
Itaru Ebihara (I)
Chihiro Sato (C)
Yukinao Sakai (Y)
Akio Hirama (A)
Akiko Mii (A)
Yoshinobu Fuke (Y)
Masanori Abe (M)
Hirokazu Okada (H)
Tsutomu Inoue (T)
Takatsugu Iwashita (T)
Yuta Kogure (Y)
Koichi Kanozawa (K)
Hajime Hasegawa (H)
Masamitsu Ubukata (M)
Takanori Shibata (T)
Yoshihiko Inoue (Y)
Tomo Suzuki (T)
Daisuke Ichikawa (D)
Sayuri Shirai (S)
Yugo Shibagaki (Y)
Takehiko Wada (T)
Masafumi Fukagawa (M)
Yoshihide Fujigaki (Y)
Shigeo Horie (S)
Satoru Muto (S)
Masaki Kobayashi (M)
Kouichi Hirayama (K)
Homare Shimohata (H)
Riku Hamada (R)
Hiroshi Hataya (H)
Motoshi Hattori (M)
Kenichiro Miura (K)
Kiyonobu Ishizuka (K)
Naoto Kaneko (N)
Kosaku Nitta (K)
Keiko Uchida (K)
Takahito Moriyama (T)
Yoshifumi Ubara (Y)
Tatsuya Suwabe (T)
Junichi Hoshino (J)
Noriko Hayami (N)
Masaomi Nangaku (M)
Tetsuhiro Tanaka (T)
Yoshifumi Hamasaki (Y)
Kenjiro Honda (K)
Yutaka Harita (Y)
Shoichiro Kanda (S)
Yuko Kajiho (Y)
Kunihiro Yamagata (K)
Joichi Usui (J)
Tetsuya Kawamura (T)
Kouichi Tamura (K)
Hiromichi Wakui (H)
Tomohiko Kanaoka (T)
Ryu Kobayashi (R)
Nobuhito Hirawa (N)
Sanae Saka (S)
Akira Fujiwara (A)
Ichiei Narita (I)
Shin Goto (S)
Yumi Itoh (Y)
Naofumi Imai (N)
Yuji Kamijo (Y)
Koji Hashimoto (K)
Akinori Yamaguchi (A)
Sonoda Kosuke (S)
Kazuya Takahashi (K)
Fumihiko Furuya (F)
Kiyoki Kitagawa (K)
Hitoshi Yokoyama (H)
Keiji Fujimoto (K)
Norifumi Hayashi (N)
Daisuke Koya (D)
Munehiro Kitada (M)
Yuka Kuroshima (Y)
Takashi Wada (T)
Kengo Furuichi (K)
Miho Shimizu (M)
Norihiko Sakai (N)
Yasuhiro Katou (Y)
Yuta Yamamura (Y)
Yoshitaka Koshino (Y)
Chikako Takaeda (C)
Haruyoshi Yoshida (H)
Takayasu Horiguchi (T)
Yasuyuki Shinozaki (Y)
Masahiko Kawabata (M)
Satoshi Ota (S)
Yoh-Ichi Ishida (YI)
Masayuki Iwano (M)
Naoki Takahashi (N)
Kenji Kasuno (K)
Daisuke Mikami (D)
Hidenori Yamazaki (H)
Naoya Fujita (N)
Satoshi Hibino (S)
Kazuki Tanaka (K)
Yasuhiko Ito (Y)
Takuhito Nagai (T)
Takayuki Katsuno (T)
Hironobu Nobata (H)
Shogo Kimura (S)
Yuka Soga (Y)
Masanori Sakakima (M)
Yukio Yuzawa (Y)
Naotake Tsuboi (N)
Hiroki Hayashi (H)
Kazuo Takahashi (K)
Hideo Yasuda (H)
Naro Ohashi (N)
Taichi Sato (T)
Asami Takeda (A)
Yasuhiro Otsuka (Y)
Minamo Ono (M)
Tatsuya Tomonari (T)
Michio Fukuda (M)
Masashi Mizuno (M)
Taisei Suzuki (T)
Satoru Kominato (S)
Hirotake Kasuga (H)
Shoichi Maruyama (S)
Yoshinari Yasuda (Y)
Tomoki Kosugi (T)
Takuji Ishimoto (T)
Noriko Mori (N)
Satoshi Tanaka (S)
Tomohiro Murata (T)
Mika Fujimoto (M)
Kan Katayama (K)
Yokkaichi Hazu (Y)
Yasuhide Mizutani (Y)
Hitoshi Kodera (H)
Masato Miyake (M)
Kazumasa Oka (K)
Nobuyuki Kajiwara (N)
Tatsuo Tsukamoto (T)
Tomomi Endo (T)
Eri Muso (E)
Shinichi Nishi (S)
Shunsuke Goto (S)
Kazumoto Iijima (K)
Kandai Nozu (K)
Tomohiko Yamamura (T)
Yoko Adachi (Y)
Takaaki Nishihara (T)
Michitsugu Kamezaki (M)
Koichi Seta (K)
Kensei Yahata (K)
Keiichi Tamagaki (K)
Tetsuro Kusaba (T)
Yayoi Shiotsu (Y)
Motoko Yanagita (M)
Hideki Yokoi (H)
Kaoru Sakai (K)
Akira Ishii (A)
Kazuhiko Tsuruya (K)
Kenichi Samejima (K)
Fumiki Yoshihara (F)
Katsuhito Mori (K)
Akihiro Tsuda (A)
Shinya Nakatani (S)
Yoshio Konishi (Y)
Takashi Morikawa (T)
Chizuko Kitabayashi (C)
Rika Fujimaru (R)
Terumasa Hayashi (T)
Tatsuya Shoji (T)
Katsusuke Yamamoto (K)
Akira Ashida (A)
Akira Sugawara (A)
Masao Koshikawa (M)
Yoshihisa Ogawa (Y)
Tomoko Kawanishi (T)
Atsushi Yamauchi (A)
Katsuyuki Nagatoya (K)
Daisuke Mori (D)
Ryota Haga (R)
Yoshitaka Isaka (Y)
Ryohei Yamamoto (R)
Tomoko Namba (T)
Toshiki Nishio (T)
Shinichi Araki (S)
Shigeichi Shoji (S)
Kenjiro Yamakawa (K)
Senji Okuno (S)
Megumu Fukunaga (M)
Yuko Shima (Y)
Taketsugu Hama (T)
Takashi Shigematsu (T)
Masaki Ohya (M)
Naoki Kashihara (N)
Kenichiro Asano (K)
Motoko Kanzaki (M)
Kosuke Fukuoka (K)
Takao Masaki (T)
Shigehiro Doi (S)
Ayumu Nakashima (A)
Toshiki Doi (T)
Kan Yamazaki (K)
Nobuyoshi Sugiyama (N)
Yuichiro Inaba (Y)
Kouji Ozeki (K)
Makoto Hiramatsu (M)
Keisuke Maruyama (K)
Noriya Momoki (N)
Hiroshi Morinaga (H)
Ayu Akiyama (A)
Natsumi Uchiyama (N)
Mariko Nishiwaki (M)
Tsuyoshi Imai (T)
Takafumi Ito (T)
Masahiro Egawa (M)
Shohei Fukunaga (S)
Shinichi Okada (S)
Koichi Kitamoto (K)
Hiroki Yokoyama (H)
Yuko Yamada (Y)
Tadashi Sofue (T)
Tetsuo Minamino (T)
Emi Ibuki (E)
Yoshio Terada (Y)
Taro Horino (T)
Yoshiko Shimamura (Y)
Tatsuki Matsumoto (T)
Mikiya Fujieda (M)
Masayuki Ishihara (M)
Shoji Kagami (S)
Maki Urushihara (M)
Yukiko Kinoshita (Y)
Hideharu Abe (H)
Kojiro Nagai (K)
Kosuke Masutani (K)
Tetsuhiko Yasuno (T)
Kenji Ito (K)
Ken Hatae (K)
Manao Nishimura (M)
Hiroyo Maruyama (H)
Koji Mitsuiki (K)
Masashi Mukoyama (M)
Masataka Adachi (M)
Kei Fukami (K)
Junko Yano (J)
Toshiaki Nakano (T)
Akihiro Tsuchimoto (A)
Shunsuke Yamada (S)
Yuta Matsukuma (Y)
Yutaka Kiyohara (Y)
Toshiharu Ninomiya (T)
Masaharu Nagata (M)
Naoko Yokota-Ikeda (N)
Keiko Kodama (K)
Takashi Taguchi (T)
Tomoya Nishino (T)
Yoko Obata (Y)
Tadashi Uramatsu (T)
Ritsuko Katafuchi (R)
Masaru Nakayama (M)
Ryokichi Yasumori (R)
Motoaki Miyazono (M)
Eriko Nonaka (E)
Shuichi Rikitake (S)
Makoto Fukuda (M)
Harumichi Higashi (H)
Shouichi Fujimoto (S)
Yuji Sato (Y)
Masao Kikuchi (M)
Akihiro Minakawa (A)
Masahito Tamura (M)
Tetsu Miyamoto (T)
Yusuke Ohya (Y)
Kentaro Kohagura (K)

Informations de copyright

© 2021. Japanese Society of Nephrology.

Références

Hattori M, Iwano M, Sako M, Honda M, Okada H, Akioka Y, et al. Transition of adolescent and young adult patients with childhood-onset chronic kidney disease from pediatric to adult renal services: a nationwide survey in Japan. Clin Exp Nephrol. 2016;20:918–25. https://doi.org/10.1007/s10157-016-1231-6 .
doi: 10.1007/s10157-016-1231-6 pubmed: 26780894
Dallimore DJ, Neukirchinger B, Noyes J. Why is transition between child and adult services a dangerous time for young people with chronic kidney disease? A mixed-method systematic review. PLoS ONE. 2018;13:e0201098. https://doi.org/10.1371/journal.pone.0201098 .
doi: 10.1371/journal.pone.0201098 pubmed: 30071028 pmcid: 6071995
Watson AR, Harden PN, Ferris ME, Kerr PG, Mahan JD, Ramzy MF, et al. Transition from pediatric to adult renal services: a consensus statement by the International Society of Nephrology (ISN) and the International Pediatric Nephrology Association (IPNA). Kidney Int. 2011;80:704–7. https://doi.org/10.1038/ki.2011.209 .
doi: 10.1038/ki.2011.209 pubmed: 21832978
Foreman JW, Chan JC. Chronic renal failure in infants and children. J Pediatr. 1988;113:793–800. https://doi.org/10.1016/s0022-3476(88)80003-9 .
doi: 10.1016/s0022-3476(88)80003-9 pubmed: 3054033
Ingelfinger JR, Kalantar-Zadeh K, Schaefer F. Averting the legacy of kidney disease: focus on childhood. Future Sci OA. 2016;2:FSO112. https://doi.org/10.4155/fsoa-2016-0001 .
Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, et al. Japan renal biopsy registry and Japan kidney disease registry: committee report for 2009 and 2010. Clin Exp Nephrol. 2013;17:155–73. https://doi.org/10.1007/s10157-012-0746-8 .
doi: 10.1007/s10157-012-0746-8 pubmed: 23385776
Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92. https://doi.org/10.1053/j.ajkd.2008.12.034 .
doi: 10.1053/j.ajkd.2008.12.034 pubmed: 19339088
Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Gotoh Y, et al. Creatinine-based equation to estimate the glomerular filtration rate in Japanese children and adolescents with chronic kidney disease. Clin Exp Nephrol. 2014;18:626–33. https://doi.org/10.1007/s10157-013-0856-y .
doi: 10.1007/s10157-013-0856-y pubmed: 24013764
Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, et al. 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. https://doi.org/10.1007/s10157-011-0430-4 .
doi: 10.1007/s10157-011-0430-4 pubmed: 21437579
van Husen M, Kemper MJ. New therapies in steroid-sensitive and steroid-resistant idiopathic nephrotic syndrome. Pediatr Nephrol. 2011;26:881–92. https://doi.org/10.1007/s00467-010-1717-5 .
doi: 10.1007/s00467-010-1717-5 pubmed: 21229269
Nephrotic syndrome in children: prediction of histopathology from clinical and laboratory characteristics at time of diagnosis. A report of the International Study of Kidney Disease in Children. Kidney Int. 1978;13:159–65. https://doi.org/10.1038/ki.1978.23 .
Mohapatra A, Kakde S, Annapandian VM, Valson AT, Duhli N, Korula A, et al. Spectrum of biopsy proven renal disease in South Asian children: two decades at a tropical tertiary care centre. Nephrol (Carlt). 2018;23:1013–22. https://doi.org/10.1111/nep.13160 .
doi: 10.1111/nep.13160
Coppo R, Gianoglio B, Porcellini MG, Maringhini S. Frequency of renal diseases and clinical indications for renal biopsy in children (report of the Italian National Registry of Renal Biopsies in Children). Group of Renal Immunopathology of the Italian Society of Pediatric Nephrology and Group of Renal Immunopathology of the Italian Society of Nephrology. Nephrol Dial Transplant. 1998;13:293–7. https://doi.org/10.1093/oxfordjournals.ndt.a027821 .
Woo KT, Chan CM, Lim C, Choo J, Chin YM, Teng EWL, et al. A global evolutionary trend of the frequency of primary glomerulonephritis over the past four decades. Kidney Dis (Basel). 2019;5:247–58. https://doi.org/10.1159/000500142 .
doi: 10.1159/000500142
Nie S, He W, Huang T, Liu D, Wang G, Geng J, et al. The spectrum of biopsy-proven glomerular diseases among children in China: a national, cross-sectional survey. Clin J Am Soc Nephrol. 2018;13:1047–54. https://doi.org/10.2215/CJN.11461017 .
doi: 10.2215/CJN.11461017 pubmed: 29915132 pmcid: 6032591
Hu R, Quan S, Wang Y, Zhou Y, Zhang Y, Liu L, et al. Spectrum of biopsy proven renal diseases in Central China: a 10-year retrospective study based on 34,630 cases. Sci Rep. 2020;10:10994. https://doi.org/10.1038/s41598-020-67910-w .
doi: 10.1038/s41598-020-67910-w pubmed: 32620914 pmcid: 7335090
O’Shaughnessy MM, Hogan SL, Poulton CJ, Falk RJ, Singh HK, Nickeleit V, et al. Temporal and demographic trends in glomerular disease epidemiology in the southeastern United States, 1986–2015. Clin J Am Soc Nephrol. 2017;12:614–23. https://doi.org/10.2215/CJN.10871016 .
doi: 10.2215/CJN.10871016 pubmed: 28325866 pmcid: 5383393
Polito MG, de Moura LA, Kirsztajn GM. An overview on frequency of renal biopsy diagnosis in Brazil: clinical and pathological patterns based on 9,617 native kidney biopsies. Nephrol Dial Transplant. 2010;25:490–6. https://doi.org/10.1093/ndt/gfp355 .
doi: 10.1093/ndt/gfp355 pubmed: 19633091
Fidan K, Isik Gonul I, Buyukkaragoz B, Isiyel E, Arinsoy T, Soylemezoglu O. Changing trends in pediatric renal biopsies: analysis of pediatric renal biopsies in national nephrology registry data. Ren Fail. 2016;38:1228–33. https://doi.org/10.1080/0886022X.2016.1209070 .
doi: 10.1080/0886022X.2016.1209070 pubmed: 27430296
Alwahaibi NY, Al Issaei HK, Al Dhahli BS. Incidence of pediatric glomerular diseases in Arab world: a systematic review. Saudi J Kidney Dis Transpl. 2019;30:15–23.
doi: 10.4103/1319-2442.252904
Yokoyama H, Taguchi T, Sugiyama H, Sato H, Committee for the Standardization of Renal Pathological D, for Renal B et al. Membranous nephropathy in Japan: analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol. 2012;16:557–63. https://doi.org/10.1007/s10157-012-0593-7 .
Komatsu H, Fujimoto S, Yoshikawa N, Kitamura H, Sugiyama H, Yokoyama H. Clinical manifestations of Henoch-Schonlein purpura nephritis and IgA nephropathy: comparative analysis of data from the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol. 2016;20:552–60. https://doi.org/10.1007/s10157-015-1177-0 .
doi: 10.1007/s10157-015-1177-0 pubmed: 26456327

Auteurs

Maki Urushihara (M)

Department of Pediatrics, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan. urushihara@tokushima-u.ac.jp.

Hiroshi Sato (H)

Deparment of Internal Medicine, Sendai Hospital of East Japan Railway Company, Sendai, Japan.

Akira Shimizu (A)

Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan.

Hitoshi Sugiyama (H)

Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Hitoshi Yokoyama (H)

Department of Nephrology, Kanazawa Medical University, Uchinada, Japan.

Hiroshi Hataya (H)

Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Kentaro Matsuoka (K)

Department of Pathology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Takayuki Okamoto (T)

Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.

Daisuke Ogino (D)

Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan.

Kenichiro Miura (K)

Depatment of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.

Riku Hamada (R)

Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Satoshi Hibino (S)

Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Obu, Japan.

Yuko Shima (Y)

Department of Pediatrics, Wakayama Medical University, Wakayama City, Wakayama, Japan.

Tomohiko Yamamura (T)

Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.

Koichi Kitamoto (K)

Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan.

Masayuki Ishihara (M)

Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan.

Takao Konomoto (T)

Division of Pediatrics, Department of Reproductive and Developmental Medicine Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Motoshi Hattori (M)

Depatment of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.

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