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A new classification of Diabetic Nephropathy 2014: a report from Joint Committee on Diabetic Nephropathy

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Abstract

The Joint Committee on Diabetic Nephropathy has revised its Classification of Diabetic Nephropathy (Classification of Diabetic Nephropathy 2014) in line with the widespread use of key concepts, such as the estimated glomerular filtration rate (eGFR) and chronic kidney disease. In revising the Classification, the Committee carefully evaluated, as relevant to current revision, the report of a study conducted by the Research Group of Diabetic Nephropathy, Ministry of Health, Labour and Welfare of Japan. Major revisions to the Classification are summarized as follows: (1) eGFR is substituted for GFR in the Classification; (2) the subdivisions A and B in stage 3 (overt nephropathy) have been reintegrated; (3) stage 4 (kidney failure) has been redefined as a GFR less than 30 mL/min/1.73 m2, regardless of the extent of albuminuria; and (4) stress has been placed on the differential diagnosis of diabetic nephropathy versus non-diabetic kidney disease as being crucial in all stages of diabetic nephropathy.

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References

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Acknowledgments

The Joint Committee on Diabetic Nephropathy would like to extend its heartfelt thanks to all investigators in the Research Group of Diabetic Nephropathy, Ministry of Health, Labour and Welfare of Japan for their contributions, which provided the basis for the current revision.

Conflict of interest

Masakazu Haneda has received speaker honoraria from pharmaceutical companies Boehringer Ingelheim GmbH, Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Pharma Ltd., Daiichi-Sankyo Co., Ltd., Taisho Pharmaceutical Co., Ltd., Sanofi K.K., Merck Sharp & Dohme, Astellas Pharma Inc., Kyowa Hakko Kirin Co., Ltd., Kowa Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Novartis Pharma K.K., scholarship grants from Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Co., Ltd., Novo Nordisk Pharma Ltd., Merck Sharp & Dohme, Boehringer Ingelheim GmbH, and Eli Lilly and Company, Daisuke Koya has received speaker honoraria from pharmaceutical companies Mitsubishi Tanabe Pharma Corporation, Boehringer Ingelheim GmbH, and Eli Lilly and Company, research grants from Mitsubishi Tanabe Pharma Corporation, Boehringer Ingelheim GmbH, Japan Tabacco Inc., Eli Lilly and Company, and Ono Pharmaceutical Co., Ltd., Tetsuya Babazono has received speaker honoraria from pharmaceutical company Merck Sharp & Dohme, Tatsumi Moriya has received travel expenses from pharmaceutical companies Astellas Pharma Inc., Takeda Pharmaceutical Co., Ltd., Novo Nordisk Pharma Ltd., and Daiichi-Sankyo Co., Ltd., Hirofumi Makino has received speaker honoraria from pharmaceutical companies AbbVie GK, Astellas Pharma Inc., Boehringer Ingelheim GmbH, Daiichi-Sankyo Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Merck Sharp & Dohme, Novartis Pharma K.K., Pfizer Japan Inc., Takeda Pharmaceutical Co., and Mitsubishi Tanabe Pharma Corporation, research grants from Project for accelerating Practice and Research on Community Medicine in Okayama Prefecture, scholarship grants from Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Merck Sharp & Dohme, Takeda Pharmaceutical Co., Ltd., and Mitsubishi Tanabe Pharma Corporation, Kenjiro Kimura has received research grants from pharmaceutical companies Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Limited., Boehringer Ingelheim GmbH, Baxter International Inc., and Sekisui Medical Co., Ltd., Takashi Wada has received speaker honoraria from pharmaceutical company Daiichi-Sankyo Co., Ltd., scholarship grants from Chugai pharmaceutical Co., Ltd., Susumu Ogawa has received speaker honoraria from pharmaceutical companies Daiichi-Sankyo Co., Ltd., Eli Lilly and Company, and Novo Nordisk Pharma Ltd., research grants from Daiichi-Sankyo Co., Ltd., Masaaki Inaba has received speaker honoraria from pharmaceutical companies Bayer Yakuhin, Ltd., Takeda Pharmaceutical Co., Ltd., Merck Sharp & Dohme, Kyowa Hakko Kirin Co., Ltd., and Asahi Kasei Pharma Corporation, research grants from Bayer Yakuhin, Ltd., Kyowa Hakko Kirin Co., Ltd., and Eli Lilly and Company, Yoshihiko Kanno has received scholarship grants from pharmaceutical company Chugai Pharmaceutical Co., Ltd., travel expenses from Abbott Japan Co., Ltd., Takashi Shigemats has received research grants from pharmaceutical company Bayer Yakuhin, Ltd., Kazunori Utsunomiya, Yoshiki Suzuki, Ikuto Masakane, Ken Tsuchiya, Keiko Honda, Kazuko Ichikawa, Kenichiro Shide have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by the any of the authors.

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Authors and Affiliations

  1. Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University, 1-1-1 Higashi-Nijyo, Midorigaoka, Asahikawa, Hokkaido, 078-8510, Japan

    Masakazu Haneda

  2. Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Kazunori Utsunomiya

  3. Department of Diabetology and Endocrinology, Kanazawa Medical University, 1-1 Uchinadamachi-daigaku, Kahoku-gun, Ishikawa, 920-0293, Japan

    Daisuke Koya

  4. Department of Medicine, Diabetes Center, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Tetsuya Babazono

  5. Health Care Center, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Tatsumi Moriya

  6. Okayama University Hospital, 2-5-1 Shikada-machi, Kita-ku, Okayama, 700-8558, Japan

    Hirofumi Makino

  7. Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Kenjiro Kimura

  8. Health Administration Center, Niigata University, 2-8085 Igarashi, Nishi-ku, Niigata, Niigata, 950-2181, Japan

    Yoshiki Suzuki

  9. Division of Nephrology, Department of Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan

    Takashi Wada

  10. Center for the Advancement of Higher Education, Tohoku University, 1-1 Seiryou-cho, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Susumu Ogawa

  11. Department of Metabolism, Endocrinology, Molecular Medicine, Faculty of Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-cho, Abeno-ku, Osaka, Osak, 545-8585, Japan

    Masaaki Inaba

  12. Department of Nephrology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Yoshihiko Kanno

  13. Division of Nephrology, Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509, Japan

    Takashi Shigematsu

  14. Department of Nephrology, Yabuki Hospital, 4-5-5 Shimakita, Yamagata, Yamagata, 990-0885, Japan

    Ikuto Masakane

  15. Department of Internal Medicine IV, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Ken Tsuchiya

  16. Division of Medicine/Nutrition, Department of Applied Nutrition, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado, Saitama, 350-0288, Japan

    Keiko Honda

  17. Department of Nutrition, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Hiroshima, 701-0192, Japan

    Kazuko Ichikawa

  18. Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, 54 Shogoinkawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Kenichiro Shide

  19. Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, 1-1 Seiryou-cho, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Susumu Ogawa

Authors
  1. Masakazu Haneda
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  2. Kazunori Utsunomiya
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  3. Daisuke Koya
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  4. Tetsuya Babazono
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  5. Tatsumi Moriya
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  6. Hirofumi Makino
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  7. Kenjiro Kimura
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  8. Yoshiki Suzuki
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  9. Takashi Wada
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  10. Susumu Ogawa
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  11. Masaaki Inaba
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  12. Yoshihiko Kanno
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  13. Takashi Shigematsu
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  14. Ikuto Masakane
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  15. Ken Tsuchiya
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  16. Keiko Honda
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  17. Kazuko Ichikawa
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  18. Kenichiro Shide
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Corresponding author

Correspondence to Masakazu Haneda.

Additional information

Japan Diabetes Society, Japanese Society of Nephrology, Japanese Society for Dialysis Therapy, and Japan Society of Metabolism and Clinical Nutrition established the Joint Committee on Diabetic Nephropathy, which published the revised Classification of Diabetic Nephropathy 2014 in Japanese [1–4]. This is the English version of that revision.

This article has been jointly published in Diabetology International by the Japan Diabetes Society and Clinical and Experimental Nephrology (doi:10.1007/s10157-014-1057-z) by Japanese Society of Nephrology.

The following authors are members of Japan Diabetes Society: Masakazu Haneda, Kazunori Utsunomiya, Daisuke Koya, Tetsuya Babazono, Tatsumi Moriya.

The following authors are members of Japanese Society of Nephrology: Hirofumi Makino, Kenjiro Kimura, Yoshiki Suzuki, Takashi Wada, Susumu Ogawa.

The following authors are members of Japanese Society for Dialysis Therapy: Masaaki Inaba, Yoshihiko Kanno, Takashi Shigematsu, Ikuto Msakakane, Ken Tsuchiya.

The following authors are members of Japan Society of Metabolism and Clinical Nutrition: Keiko Honda, Kazuko Ichikawa, Kenichiro Shide.

Appendix

Appendix

Relationship between the 2014 categories for diabetic nephropathy stages and the CKD severity categories

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Haneda, M., Utsunomiya, K., Koya, D. et al. A new classification of Diabetic Nephropathy 2014: a report from Joint Committee on Diabetic Nephropathy. Diabetol Int 5, 207–211 (2014). https://doi.org/10.1007/s13340-014-0197-4

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  • DOI: https://doi.org/10.1007/s13340-014-0197-4

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