Temporal Changes in Post-Infectious Glomerulonephritis in Japan (1976-2009).
BACKGROUND
The incidence of post-infectious glomerulonephritis (PIGN) in developed countries has decreased over the last 50 years. Here we identified the trends of the incidence of PIGN in Japan during the past four decades.


METHODS
We explored the frequency, clinicopathological findings, and prognosis of PIGN based on 6,369 cases from the Renal Biopsy Database of our institute in the Kanto region of Japan, diagnosed histologically from 1976 to 2009.


RESULTS
The numbers of PIGN cases were 131 (2.1%) in total, and 2.4%, 1.1%, 2.6% and 2.1% identified in the 1970s, 1980s, 1990s, and 2000s, respectively. Acute glomerulonephritis (AGN), including post-streptococcal glomerulonephritis (PSGN), accounted for almost all of the PIGN cases in the 1970s, but decreased to approx. 40%-50% since the 1990s. In the 1990s, Staphylococcus aureus infection-related nephritis (SARN) showed a rapid increase in rate, reaching 30%. The incidence of hepatitis C virus infection-associated GN (HCVGN) has increased since the 1990s. The average age at onset rose from 33 to 51 years over the study period. These transitions can be summarized as increases in SARN and HCVGN and decreases in PSGN and other types of AGN, since SARN and HCVGN have older onsets compared to PSGN and other AGN types. The clinicopathological features were marked for each PIGN. Regarding the prognosis, the renal death rates of both the SARN and HCVGN groups were significantly higher than those of other PIGN.


CONCLUSIONS
Based on our analysis of the Renal Biopsy Database, the incidence of PIGN in Japan reached its peak in the 1990s. The temporal changes in the incidence of PIGN reflected the trends in infectious diseases of each decade and the continual aging of the population, with a related higher susceptibility to infections.
Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Joichi
J
Usui
Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Takashi
T
Tawara-Iida
Department of Nephrology, Tsukuba Gakuen Hospital, Tsukuba, Ibaraki, Japan.
Kenji
K
Takada
Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
Itaru
I
Ebihara
Department of Nephrology, Hitachi General Hospital, Hitachi, Ibaraki, Japan.
Atsushi
A
Ueda
Department of Medicine, Kensei General Hospital, Sakuragawa, Ibaraki, Japan.
Satoshi
S
Iwabuchi
Department of Nephrology, Tsukuba Central Hospital, Ushiku, Ibaraki, Japan.
Takashi
T
Ishizu
Department of Nephrology, Ibaraki Seinan Medical Center Hospital, Sakai, Ibaraki, Japan.
Tadashi
T
Iitsuka
Takemura Nephrology Clinic, Kanuma, Tochigi, Japan.
Katsumi
K
Takemura
Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Tetsuya
T
Kawamura
Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Shuzo
S
Kaneko
Department of Nephrology, Ibaraki Seinan Medical Center Hospital, Sakai, Ibaraki, Japan.
Kentaro
K
Sakai
Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Hirayasu
H
Kai
The School of Public Health, The University of Tokyo, Tokyo, Japan.
Tomoka
T
Gomibuchi
Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Michio
M
Nagata
Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, Japan.
Masaki
M
Kobayashi
Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan.|Ibaraki Prefectural University, Ami, Ibaraki, Japan.
Akio
A
Koyama
Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Machi
M
Suka
Division of Nephrology, Columbia University Medical Center, New York, New York, United States of America.
Jai
J
Radhakrishnan
Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Kunihiro
K
Yamagata
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D005921:Glomerulonephritis / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology; D055815:Young Adult