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Article ; Online: Changes in Treatment Conditions for Patients Receiving Hemodialysis at Nippon Medical School Hospital During the COVID-19 Pandemic.

Shimoda, Naoko / Sakai, Yukinao / Nishino, Takuya / Kawasaki, Sayuri / Hirama, Akio / Kashiwagi, Tetsuya / Iwabu, Masato

Journal of Nippon Medical School = Nippon Ika Daigaku zasshi

2024

Abstract: Background: The COVID-19 pandemic has had an enormous impact on hemodialysis patients. This study investigated changes in hemodialysis treatment at our hospital after the start of the pandemic.: Methods: We analyzed data from the Diagnosis Procedure ... ...

Abstract	Background: The COVID-19 pandemic has had an enormous impact on hemodialysis patients. This study investigated changes in hemodialysis treatment at our hospital after the start of the pandemic. Methods: We analyzed data from the Diagnosis Procedure Combination (DPC) system. Data for inpatients receiving dialysis during collection periods A (before the COVID-19 pandemic) and B (after the start of the COVID-19 pandemic) were extracted and compared. The numbers of inpatients and new patients, the number of patients admitted (by department), duration of stay, mortality, place of residence, surgical procedures, and DPC classification were compared. Results: There were no significant differences between periods in patient age, duration of hospital stay, number of new patients, number of ambulance transports, number of deaths, body mass index, comorbidities, laboratory variables before the first dialysis after hospitalization, or patient area of residence. Although differences were observed among the departments, the numbers of emergency dialysis inpatients and maintenance dialysis inpatients increased. The number of surgeries also increased overall, particularly for maintenance dialysis patients (P = 0.0273). The percentage of DPC III patients was significantly higher in period B (P=0.0368). Conclusions: The number of surgeries performed on maintenance dialysis patients and the overall DPC III rate significantly increased after the start of the COVID-19 pandemic at our hospital, suggesting that COVID-19 worsened the condition of maintenance dialysis patients and prolonged hospital stays.
Language	English
Publishing date	2024-03-02
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2091563-9
ISSN	1347-3409 ; 1345-4676
ISSN (online)	1347-3409
ISSN	1345-4676
DOI	10.1272/jnms.JNMS.2024_91-207
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Article: [Drug-induced kidney injury: definition, classification and diagnosis].

Sakai, Yukinao / Tsuruoka, Shuichi

Nihon Jinzo Gakkai shi

2019 Volume 58, Issue 7, Page(s) 1051–1054

MeSH term(s)	Acute Kidney Injury/chemically induced ; Acute Kidney Injury/classification ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/pathology ; Humans ; Practice Guidelines as Topic
Language	Japanese
Publishing date	2019-01-08
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1195538-7
ISSN	0385-2385
ISSN	0385-2385
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Article ; Online: Effects of Renal Function on Urinary Excretion and Serum Concentration of Uric Acid in Patients Treated with Febuxostat for Chronic Kidney Disease.

Yamada, Takehisa / Kashiwagi, Tetsuya / Sakai, Yukinao

Journal of Nippon Medical School = Nippon Ika Daigaku zasshi

2021 Volume 89, Issue 4, Page(s) 360–367

Abstract: Background: Febuxostat is recommended for lowering serum uric acid (sUA) concentration in chronic kidney disease (CKD) patients with hyperuricemia. However, it remains uncertain how febuxostat affects associations between several laboratory variables ... ...

Abstract	Background: Febuxostat is recommended for lowering serum uric acid (sUA) concentration in chronic kidney disease (CKD) patients with hyperuricemia. However, it remains uncertain how febuxostat affects associations between several laboratory variables related to glomerular filtration and renal tubular reabsorption of uric acid. Methods: We retrospectively analyzed the records of 148 patients with CKD and hyperuricemia: 122 were treated with febuxostat, and 26 were not. Clinical and laboratory variables were used to calculate estimated glomerular filtration rate (eGFR), fractional excretion of uric acid (FEUA), and estimated 24-h urinary excretion of uric acid (eEUA). We examined correlations of those variables and compared patients who did and did not receive febuxostat. Results: eGFR and FEUA were significantly inversely regardless of febuxostat-treatment status. eGFR was significantly inversely correlated with sUA in patients who received febuxostat, but not in those who did not. Similarly, there was a significant positive correlation between FEUA and eEUA only in patients treated with febuxostat. Conclusions: FEUA increased as eGFR decreased in our patients. Febuxostat changed correlation patterns for clinical and laboratory variables. Additional administration of uricosuric agents might help further lower sUA by increasing FEUA and eEUA in patients treated with febuxostat.
MeSH term(s)	Febuxostat ; Glomerular Filtration Rate ; Humans ; Hyperuricemia ; Kidney/physiology ; Renal Insufficiency, Chronic ; Retrospective Studies ; Uric Acid
Chemical Substances	Febuxostat (101V0R1N2E) ; Uric Acid (268B43MJ25)
Language	English
Publishing date	2021-11-26
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2091563-9
ISSN	1347-3409 ; 1345-4676
ISSN (online)	1347-3409
ISSN	1345-4676
DOI	10.1272/jnms.JNMS.2022_89-401
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Article ; Online: The efficacy and safety of ivabradine hydrochloride in hemodialysis patients with chronic heart failure.

Kawasaki, Sayuri / Sakai, Yukinao / Harasawa, Shinsuke / Inatsu, Akihito / Kubota, Yoshiaki / Hirama, Akio / Kashiwagi, Tetsuya / Iwabu, Masato

Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy

2024 Volume 28, Issue 3, Page(s) 354–363

Abstract: Introduction: There is little evidence for ivabradine hydrochloride in patients undergoing hemodialysis.: Methods: In this open-label prospective interventional trial of hemodialysis patients with chronic heart failure, during 12 weeks of treatment, ... ...

Abstract	Introduction: There is little evidence for ivabradine hydrochloride in patients undergoing hemodialysis. Methods: In this open-label prospective interventional trial of hemodialysis patients with chronic heart failure, during 12 weeks of treatment, changes in Heart rate (HR), frequency of dialysis-related hypotension were examined, and we investigated health-related quality of life (HR-QOL) and adverse effects. Results: 18 patients from 6 facilities were enrolled in the study. HR significantly decreased over time, from 87 ± 12.61/min at baseline to 75.85 ± 8.91/min (p = 0.0003), and systolic blood pressure also increased significantly (p < 0.0001). The frequency of dialysis-related hypotension was markedly reduced (p = 0.0001). The HR-QOL survey showed significant improvements in Social Functioning among others (p = 0.0178). No specific adverse events occurred. Conclusion: Ivabradine hydrochloride improved dialysis-related hypotension. Furthermore, the HR-QOL improvement effect were suggested. These results demonstrated the safety and effectiveness of ivabradine hydrochloride.
MeSH term(s)	Humans ; Ivabradine/therapeutic use ; Ivabradine/pharmacology ; Renal Dialysis/methods ; Male ; Female ; Quality of Life ; Prospective Studies ; Heart Failure/drug therapy ; Heart Failure/therapy ; Aged ; Hypotension/etiology ; Hypotension/drug therapy ; Treatment Outcome ; Middle Aged ; Heart Rate/drug effects ; Cardiovascular Agents/adverse effects ; Cardiovascular Agents/therapeutic use ; Cardiovascular Agents/pharmacology ; Benzazepines/therapeutic use ; Benzazepines/adverse effects ; Benzazepines/pharmacology ; Blood Pressure/drug effects ; Chronic Disease
Chemical Substances	Ivabradine (3H48L0LPZQ) ; Cardiovascular Agents ; Benzazepines
Language	English
Publishing date	2024-01-10
Publishing country	Australia
Document type	Journal Article ; Multicenter Study ; Clinical Trial
ZDB-ID	2119809-3
ISSN	1744-9987 ; 1091-6660 ; 1744-9979
ISSN (online)	1744-9987
ISSN	1091-6660 ; 1744-9979
DOI	10.1111/1744-9987.14107
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Article ; Online: The severity of glomerular endothelial cell injury is associated with infiltrating macrophage heterogeneity in endocapillary proliferative glomerulonephritis.

Arai, Momoko / Mii, Akiko / Kashiwagi, Tetsuya / Shimizu, Akira / Sakai, Yukinao

Scientific reports

2021 Volume 11, Issue 1, Page(s) 13339

Abstract: Endocapillary proliferation occurs in various types of glomerulonephritis (GN), with varying prognoses. We examined 42 renal biopsy samples representing endocapillary proliferative lesions from post-streptococcal acute GN (PSAGN), Henoch-Schönlein ... ...

Abstract	Endocapillary proliferation occurs in various types of glomerulonephritis (GN), with varying prognoses. We examined 42 renal biopsy samples representing endocapillary proliferative lesions from post-streptococcal acute GN (PSAGN), Henoch-Schönlein purpura nephritis (HSPN), and lupus nephritis (LN). In PSAGN, the glomerular capillary network was maintained, although severe lesions displayed dots or short, curved lines, indicating CD34-positive capillaries and suggesting capillary obstruction. Conversely, patients with LN and HSPN displayed obstruction of CD34-positive capillaries with dissociation from the glomerular basement membrane even in mild lesions. According to computer-assisted morphologic analysis, the cell density did not differ between the diseases. However, in PSAGN, the number of capillary loops was significantly increased, with a larger glomerular capillary luminal area than in the other groups. In addition, the number and frequency of CD163-positive cells (M2 macrophages) tended to be higher in PSAGN, while there were no significant differences in the number of CD68-positive (total) macrophages. These results indicate that in PSAGN, endothelial cell damage is less severe, and angiogenesis may be promoted. The severity of endothelial cell injury in each disease may be associated with differences in infiltrating inflammatory cell phenotypes.
MeSH term(s)	Acute Disease ; Adolescent ; Adult ; Antigens, CD/metabolism ; Antigens, Differentiation, Myelomonocytic/metabolism ; Capillaries/metabolism ; Capillaries/pathology ; Child ; Endothelial Cells/metabolism ; Endothelial Cells/pathology ; Female ; Glomerulonephritis, Membranoproliferative/metabolism ; Glomerulonephritis, Membranoproliferative/pathology ; Humans ; Kidney Glomerulus/metabolism ; Kidney Glomerulus/pathology ; Lupus Nephritis/metabolism ; Lupus Nephritis/pathology ; Macrophages/metabolism ; Macrophages/pathology ; Male ; Middle Aged ; Prognosis ; Purpura, Schoenlein-Henoch/metabolism ; Purpura, Schoenlein-Henoch/pathology ; Receptors, Cell Surface/metabolism ; Young Adult
Chemical Substances	Antigens, CD ; Antigens, Differentiation, Myelomonocytic ; CD163 antigen ; Receptors, Cell Surface
Language	English
Publishing date	2021-06-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-92655-5
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Article ; Online: Risk Factors for Early Peritoneal Dialysis Discontinuation: Importance of Heart Failure.

Terada, Kohsuke / Sumi, Yuichiro / Hirama, Akio / Kashiwagi, Tetsuya / Sakai, Yukinao

Journal of Nippon Medical School = Nippon Ika Daigaku zasshi

2021 Volume 89, Issue 1, Page(s) 72–80

Abstract: Background: The number of patients on peritoneal dialysis (PD) in our hospital has increased during the past 5 years, but the number discontinuing PD has also increased. The purpose of this study was to identify the risk factors for PD discontinuation ... ...

Abstract	Background: The number of patients on peritoneal dialysis (PD) in our hospital has increased during the past 5 years, but the number discontinuing PD has also increased. The purpose of this study was to identify the risk factors for PD discontinuation by analyzing the association between technical survival period (defined as the duration of PD) and various clinical factors. Methods: We retrospectively investigated 87 patients who were started on PD at our hospital and attended regularly from April 2015 to March 2020, and we analyzed the association between technical survival period and various clinical factors. We also looked for associations between technical survival period and hospitalizations for heart failure, peritonitis, and exit-site infections among patients undergoing PD. Results: The patients using renin-angiotensin-aldosterone system inhibitors (RASi) (P = 0.0218), those with left ventricular ejection fraction (LVEF) > 50% (P = 0.0194) when they started PD, and those with estimated glomerular filtration rate (eGFR) ≥ 6 (mL/min/1.73 m Conclusion: Treatment of RASi, LVEF > 50% and eGFR ≥ 6 mL/ min/1.73 m
MeSH term(s)	Heart Failure/etiology ; Heart Failure/therapy ; Humans ; Kidney Failure, Chronic/etiology ; Peritoneal Dialysis/adverse effects ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Ventricular Function, Left
Language	English
Publishing date	2021-04-19
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2091563-9
ISSN	1347-3409 ; 1345-4676
ISSN (online)	1347-3409
ISSN	1345-4676
DOI	10.1272/jnms.JNMS.2022_89-201
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Article: Lower Limb Ulcer Associated with Peritonitis in Patients Undergoing Peritoneal Dialysis.

Terada, Kohsuke / Aratani, Sae / Hirama, Akio / Kashiwagi, Tetsuya / Sakai, Yukinao

International journal of nephrology and renovascular disease

2021 Volume 14, Page(s) 33–40

Abstract: Purpose: Peritoneal dialysis (PD)-related peritonitis and lower limb ulcer are the important complications in patients undergoing PD. Although the association between lower limb ulcer and peritonitis in patients undergoing PD is unclear, based on our ... ...

Abstract	Purpose: Peritoneal dialysis (PD)-related peritonitis and lower limb ulcer are the important complications in patients undergoing PD. Although the association between lower limb ulcer and peritonitis in patients undergoing PD is unclear, based on our clinical experience and the clinical importance of the complications in patients undergoing PD, we hypothesized that lower limb ulcer is associated with peritonitis in patients on PD. Patients and methods: In this single center, retrospective cohort study, we studied 87 patients who started undergoing PD at our hospital from April 2015 to March 2020. We compared these 8 patients with lower limb ulcer with the other 79 patients without lower limb ulcer. We compared between the patients in the objection period of this study about peritonitis using Log rank test, and used the unpaired Results: The period developed first peritonitis of the patients on PD with lower limb ulcer was significant shorter than those without lower limb ulcer in Log rank test (P = 0.011). The Fisher's exact test and unpaired Conclusion: In conclusion, lower limb ulcer may be associated with peritonitis in patients undergoing PD. Further large-scale, prospective studies are required to confirm these results.
Language	English
Publishing date	2021-02-11
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2508160-3
ISSN	1178-7058
ISSN	1178-7058
DOI	10.2147/IJNRD.S295948
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Article: A Case of Hepatitis E Virus Infection: One of Differential Diagnosis of Liver Injury in Patients Undergoing Peritoneal Dialysis.

Yan, Tomohiro / Sakai, Yukinao / Terada, Kohsuke / Okano, Sho / Kawasaki, Sayuri / Kashiwagi, Tetsuya / Iwabu, Masato

International medical case reports journal

2022 Volume 15, Page(s) 557–561

Abstract: Background: There are numerous causes of liver function disorder in patients undergoing peritoneal dialysis (PD). Infection with the Hepatitis E virus (HEV) is a rare cause of liver injury, and the behavior of HEV in patients with PD is unclear. Since ... ...

Abstract	Background: There are numerous causes of liver function disorder in patients undergoing peritoneal dialysis (PD). Infection with the Hepatitis E virus (HEV) is a rare cause of liver injury, and the behavior of HEV in patients with PD is unclear. Since patients undergoing dialysis are frequently polypharmatic, liver injury caused by HEV infection may be misdiagnosed as drug-induced liver injury. Case presentation: A 61-year-old woman with PD developed abrupt elevation of blood transaminase levels on a routine outpatient session. Since the patient has been receiving tolvaptan as the only new medication, we suspected tolvaptan induced liver injury. In further investigating the cause of liver injury, the blood screening test was found to be positive for HEV-IgA. The patient was diagnosed with HEV infection, and had a self-limited course. Conclusion: When encountered with patients developing liver injury during PD, HEV infection should be included in the differential diagnosis.
Language	English
Publishing date	2022-10-10
Publishing country	New Zealand
Document type	Case Reports
ZDB-ID	2495077-4
ISSN	1179-142X
ISSN	1179-142X
DOI	10.2147/IMCRJ.S385393
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Article ; Online: Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis.

Kamijo, Natsumi / Mii, Akiko / Aratani, Sae / Kashiwagi, Tetsuya / Oda, Takashi / Shimizu, Akira / Sakai, Yukinao

Internal medicine (Tokyo, Japan)

2022 Volume 61, Issue 19, Page(s) 2917–2923

Abstract: A 44-year-old woman was admitted due to gross hematuria and progressive renal dysfunction. Poststreptococcal acute glomerulonephritis (PSAGN) was suspected due to her elevated anti-streptolysin O and anti-streptokinase titers and hypocomplementemia. A ... ...

Abstract	A 44-year-old woman was admitted due to gross hematuria and progressive renal dysfunction. Poststreptococcal acute glomerulonephritis (PSAGN) was suspected due to her elevated anti-streptolysin O and anti-streptokinase titers and hypocomplementemia. A renal biopsy showed crescent formation and endocapillary hypercellularity with neutrophil infiltrate. An immunofluorescence analysis showed granular immunoglobulin G and C3 deposition, suggesting immune-complex-type glomerulonephritis. However, myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA) was positive, and peritubular capillaritis was observed. Furthermore, citrullinated histone H3-positive neutrophils were detected as markers for neutrophil extracellular trap formation. Therefore, she was diagnosed with ANCA-associated vasculitis superimposed on PSAGN that was the main contributor to her progressive renal injury.
MeSH term(s)	Acute Disease ; Adult ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Female ; Glomerulonephritis/complications ; Glomerulonephritis/diagnosis ; Histones ; Humans ; Immunoglobulin G ; Peroxidase
Chemical Substances	Antibodies, Antineutrophil Cytoplasmic ; Histones ; Immunoglobulin G ; Peroxidase (EC 1.11.1.7)
Language	English
Publishing date	2022-03-12
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	32371-8
ISSN	1349-7235 ; 0021-5120 ; 0918-2918
ISSN (online)	1349-7235
ISSN	0021-5120 ; 0918-2918
DOI	10.2169/internalmedicine.8690-21
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Article ; Online: A possible role of classical complement pathway activation in the pathogenesis of immunoglobulin G nephropathy: a case report.

Arai, Momoko / Mii, Akiko / Hirama, Akio / Kaneko, Tomohiro / Kashiwagi, Tetsuya / Shimizu, Akira / Sakai, Yukinao

CEN case reports

2022 Volume 12, Issue 1, Page(s) 14–22

Abstract: Immunoglobulin G (IgG) nephropathy refers to a rare group of diseases characterized by deposits of IgG in the mesangial region. However, IgG nephropathy is controversial as a single disease entity, and its pathogenesis remains to be elucidated. In the ... ...

Abstract	Immunoglobulin G (IgG) nephropathy refers to a rare group of diseases characterized by deposits of IgG in the mesangial region. However, IgG nephropathy is controversial as a single disease entity, and its pathogenesis remains to be elucidated. In the present report, we discuss a case of IgG nephropathy in which we observed activation of the classical complement pathway.A 47-year-old woman was admitted to our hospital with nephrotic syndrome. Light-microscopic examination revealed neither proliferative nor sclerotic lesions in the glomeruli. However, unusual and large deposits were observed in the paramesangial area. An immunofluorescence study revealed predominant IgG and C1q and slight C3 deposits in the paramesangial area, suggesting immune-complex-type glomerular disease. An electron microscopic study also revealed different sizes of non-organized electron-dense deposits with a similar pattern of distribution, which were accompanied by foot process effacement. Clinically, there was no evidence of systemic diseases, such as infectious or autoimmune diseases (including systemic lupus erythematosus). Based on these findings, she was diagnosed with IgG nephropathy and treated with prednisolone. Steroid therapy was effective, and complete remission was maintained.Additional immunological examination revealed that IgG deposits were polyclonal and consisted mainly of the IgG1 and IgG3 subclasses. Furthermore, staining was positive for C4d and C5b-9. The present findings indicate that the pathogenesis of IgG nephropathy in our patient may have involved activation of the classical complement pathway.
MeSH term(s)	Female ; Humans ; Middle Aged ; Immunoglobulin G ; Complement Pathway, Classical ; Kidney Glomerulus/pathology ; Nephrotic Syndrome/diagnosis ; Nephrotic Syndrome/etiology ; Nephrotic Syndrome/pathology ; Glomerular Mesangium/pathology
Chemical Substances	Immunoglobulin G
Language	English
Publishing date	2022-06-16
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	2660492-9
ISSN	2192-4449 ; 2192-4449
ISSN (online)	2192-4449
ISSN	2192-4449
DOI	10.1007/s13730-022-00710-5
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