2014 56 5 547 552 2014 Classification of Diabetic Nephropathy 2014 Joint committee on diabetes nephropathy The Japanese Diabetes Society Masakazu Haneda Kazunori Utsunomiya Daisuke Koya Tetsuya Babazono Tatsumi Moriya Japanese Society of Nephrology Hirofumi Makino Kenjiro Kimura Yoshiki Suzuki Takashi Wada Susumu Ogawa The Japanese Society for Dialysis Therapy Masaaki Inaba Yoshihiko Kanno Takashi Shigematsu Ikuto Masakane Ken Tsuchiya
548 2014 Japan Society of Metabolism and Clinical Nutrition Keiko Honda Kazuko Ichikawa Kenichiro Shide estimated glomerular filtration rates egfr chronic kidney disease CKD 2014 1 GFR egfr 2 3 A B 3 GFR 30 ml 1.73 m 2 4 Key words Abstract The Committee on Diabetic Nephropathy revised the classification of diabetic nephropathy in view of the current status of egfr and CKD in Japan. To make revisions for the classification of diabetic nephropathy 2014, the Committee carefully evaluated the report of the Research Group on Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan. The major revisions made were as follows 1. egfr can be used for the evaluation of GFR 2. In stage 3 overt nephropathy, A and B were combined 3. Stage 4 renal failure was defined as GFR less than 30 ml min 1.73 m 2, regardless of albuminuria and 4. The importance of differential diagnosis was stressed in all stages. 1998 1 CKD 1 2 3 CKD CKD 4 GFR Ccr creatinine clearance CKD GFR egfr GFR egfr 2012 CKD 5 2014 10 4,355
549 egfr 6,7 1 3 2 GFR 60 ml 1.73 m 2 GFR 30 ml 1.73 m 2 1 GFR 2 3 CKD 1 GFR egfr 2 3 3 A B 1 g 4 GFR 30 ml 1.73 m 2 8 GFR 30 ml 1.73 m 2 5 6 American Diabetes Association Clinical Practice Recommendations 2013 microalbuminuria macroalbuminuria 30 g mg Cr mg g Cr Increased urinary albumin excretion 9 Clinical Practice Recommendations 2014 microalbuminuria persistent albuminuria 30 299 mg 24h macroalbuminuria persistent albuminuria 300 mg 24h 10 JDCP study Japan Diabetes Complication and the Prevention prospective study JDDM Japan Diabetes Clinical Data Management Study Group J-DOIT3 Japan Diabetes Optimal Integrated Treatment study for 3 major risk factors of cardiovascular diseases
550 2014 2014 1 mg gcr g gcr GFR egfr ml 1.73 m 2 1 30 30 2 2 3 4 5 30 299 3 300 0.5 5 30 30 4 30 1 1 5 URL http: mhlw-grants.niph.go.jp, Wada T, Haneda M, Furuichi K, Babazono T, Yokoyama H, Iseki K, Araki SI, Ninomiya T, Hara S, Suzuki Y, Iwano M, Kusano E, Moriya T, Satoh H, Nakamura H, Shimizu M, Toyama T, Hara A, Makino H The Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan. Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes. Clin Exp Nephrol. 2013 Oct 17. Epub ahead of print 2 GFR 60 ml 1.73 m 2 CKD 3 4 GFR 60 ml 1.73 m 2 GFR egfr 5 GFR 30 ml 1.73 m 2 GFR 2014 CKD A1 A2 A3 Cr mg gcr 30 30 299 300 Cr g gcr 90 0.50 60 89 1 2 3 45 59 GFR ml 1.73m 2 30 44 15 29 15 4 5
551 CKD 2014 1 10 2014 2014 MSD MSD MSD MSD MSD MSD MSD MSD MSD MSD 1. http: docs.jsdt.or.jp over view index.html 2. 3 320 3. 1 44 623 2001 4. CKD 49 767 2007 5. CKD 2012 54 1047 2012 6. 21 23 pp1 44 http: mhlw-grants. niph.go.jp 7. Wada T, Haneda M, Furuichi K, Babazono T, Yokoyama H, Iseki K, Araki SI, Ninomiya T, Hara S, Suzuki Y, Iwano M, Kusano E, Moriya T, Satoh H, Nakamura H, Shimizu M, Toyama T, Hara A, Makino H The Research Group of Diabetic Nephropathy, Min-
552 2014 istry of Health, Labour, and Welfare of Japan. Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes. Clin Exp Nephrol. 2013 Oct 17. Epub ahead of print PMID 24132561 8. 39 1 37 1997 9. Clinical Practice Recommendations 2013. Diabetes Care 36 Suppl 1 S3, S35, 2013. 10. Clinical Practice Recommendations 2014. Diabetes Care 37 Suppl 1 S4, S43 44, 2014.