Nihon Jinzo Gakkai shi最新文献

{"title":"Glomerular lesions in various types of glomerulonephritis.","authors":"Yusuke Okabayashi, Akira Shimizu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 5","pages":"622-31"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36676107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of renal function in a patient diagnosed with concurrent amyloid amyloidosis and immunoglobulin light chain amyloidosis.","authors":"Renya Watanabe,&nbsp;Kenji Ito,&nbsp;Tetsuhiko Yasuno,&nbsp;Yasuhiro Abe,&nbsp;Aki Hamauchi,&nbsp;Tomoe Yasunaga,&nbsp;Yoshie Sasatomi,&nbsp;Satoshi Hisano,&nbsp;Takao Saito,&nbsp;Hitoshi Nakashima","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case describes a 68-year-old woman exhibiting initial proteinuria at age 55. Subsequently, at age 57, a mixed-type of amyloidosis consisting of amyloid amyloidosis (A A) and immunoglobulin (Ig) light chain amyloidosis (AL) was diagnosed by a renal biopsy examination. Monoclonal paraproteinemia was concurrently identified and diagnosed as monoclonal gammopathy of undeterminate significance (MGUS). Combined melphalan and prednisolone (MP) therapy was initiated. At age 65, anti-hypertensive drugs were administered upon finding an increased urine protein concentration and elevated blood pressure. Because there was no change in the state of MGUS detected by a bone marrow biopsy examination, MP therapy was discontinued. However, the urinary protein concentration increased, and a renal biopsy was performed again at age 66. This revealed a mixed-type amyloidosis of AA and AL, as diagnosed earlier, but AL amyloid deposition in the glomeruli had increased during the intervening period. Life-preserving treatment was continued thereafter, but nephrotic syndrome and renal dysfunction progressed rapidly. End-stage renal failure deposition is rarely seen in the same individual. Although amyloidosis is generally thought to cause a rapid decline in renal function, the patient's renal function was maintained for 13 years. This could be attributed to the following factors : l)the underlying etiology of the AA amyloidosis, which was not clear, 2)a lack of any current evidence of chronic inflammation, and 3) MGUS as the cause of AL amyloidosis. This, together with MP therapy, may have slowed down the pathological decline normally associated with AL amyloidosis.</p>","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 5","pages":"668-74"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36676110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Epidemiology, prevention and treatment of drug-induced kidney injury].","authors":"Shuzo Kaneko,&nbsp;Joichi Usui,&nbsp;Kunihiro Yamagata","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 7","pages":"1055-1058"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36888024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of the angiotensin II receptor antagonist (ARB), Irbesartan, on urinary markers in hypertensive patients].","authors":"Shogo Kimura,&nbsp;Yuka Sekiya-Soga,&nbsp;Yuki Kato,&nbsp;Makoto Mizutani,&nbsp;Hiroshige Ohashi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>We examined the effect of the angiotensin II receptor antagonist (ARB), irbesartan (Irb), on urinary markers in hypertensive patients.</p><p><strong>Subjects and methods: </strong>We evaluated 87 patients in a 12-month prospective study: Group 1) 33 patients who were newly administered Irb (100 mg); Group 2) 33 patients who were switched to Irb ; and Group 3) 21 patients who did not undergo change to pre-existing Irb administration. Height, weight, systolic and diastolic blood pressure, clinical parameters, urine protein : creatinine ratio (UPC), and urinary markers (liver-type fatty acid binding protein (L-FABP), N-acetyl-β-d-glucosaminidase, α1-microglobulin, and β2-microglobulin) were measured at the baseline and at 12, 24, and 48 weeks. We examined changes in the clinical parameters, UPC, and urinary markers from the baseline.</p><p><strong>Results: </strong>A tendency toward hypotension was observed in all groups (group newly administered Irb, group switched to Irb, and group without changes to Irb), but the difference was not statistically significant. Urinary L-FABP concentration (μg/g x Cr) decreased from 13.2 --> 8.9 and13.2 --> 10.2 at 24 and 48 weeks, respectively, after administration (p < 0.01) in the group newly administered Irb, from 19.5 --> 10.1 at 48 weeks after administration (p < 0.01) in the switched group, and from 9.6 --> 8.3, 8.1, and 6.2 (p < 0.01) in the group without changes to Irb. Changes in the Irb-administered groups were readily apparent. UPC decreased in the Irb-administered groups (p < 0.05), but there were no significant differences in the other urinary markers. Changes in urinary L-FABP and UPC were positively correlated in all cases of the Irb-administered groups (r = 0.25-0.57, p < 0.05), but were not positively correlated in the group without changes to Irb administration. The change in UPC was positively correlated with changes in systolic and diastolic blood pressure in all cases (r = 0.23-0.57, p < 0.05).</p><p><strong>Conclusion: </strong>It was concluded that the urinary L-FABP level, blood pressure, and UPC of hypertensive patients should be managed in daily practice using an ARB, including Irb.</p>","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 2","pages":"104-13"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34539645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effectiveness of a practical protocol for the prevention of contrast-induced nephropathy: improved prevention of contrast-induced nephropathy].","authors":"Yoshito Yamaguchi,&nbsp;Masashi Morita,&nbsp;Akira Mega,&nbsp;Ryota Haga,&nbsp;Ikue Nagayama,&nbsp;Yu Yamanouchi,&nbsp;Tatsufumi Oka,&nbsp;Katsuyuki Nagatoya,&nbsp;Atsushi Yamauchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In Japan, \"Guidelines for iodinated contrast in a patient with chronic kidney disease (CKD) 2012\" was published, but preventive protocols for specific contrast-induced nephropathy (CIN) have not been specified. Therefore, we developed a CIN preventive protocol, and validated its operation and renal protective effect.</p><p><strong>Methods: </strong>In a retrospective cohort study, we determined eGFR within 3 months before contrast-enhanced computed tomography (CECT). We evaluated CKD stage 3b - 4 adult patients (eGFR 15 - 45 mL/min/1.73m2) who underwent CECT. We observed changes in renal function over 9 months and compared the changes between the pre-protocol group, which received CIN preventive measures from clinicians, and the post-protocol group, which received 500 mL 0.9% saline intravenously over 4 hours or drank 2,000 mL water over 36 hours.</p><p><strong>Results: </strong>The numbers of CT and CECT patients after validation of the protocol were 5,450 and 2,037, respectively. Among the CECT patients, 310 (15.2%) and 77(3.8%)had eGFRs < 60 and 45 mL/min/1.73 m2, respectively. Among the CECT patients whose eGFRs were < 60 mL/min/1.73 m2, 74.5% were 70 years or older. Tumor scanning accounted for 77% of all CECT cases. The number of CECT patients after 3 months did not significantly differ between the groups (2,189 vs 2,037). The percentage of patients with CKD stage G3b - 4 showed no significant differences (3.3% vs 3.7%, p = 0.89). The proportion of patients whose eGFR did not deteriorate at 3, 6 and 9 months was significantly higher in the post-protocol group than in the pre-protocol group (p < 0.001), and the protocol was the only independently-significant predictor.</p><p><strong>Conclusions: </strong>Our protocol prevented CIN and provided a renal protective effect without reducing the number of CECT patients.</p>","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 4","pages":"587-95"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34733289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Targeted therapy for mineral and bone disorder].","authors":"Hirotaka Komaba,&nbsp;Masafumi Fukagawa","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 4","pages":"581-6"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34733288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical Guides for Atypical Hemolytic Uremic Syndrome in Japan].","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 2","pages":"62-75"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34476009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicpathological findings in membranous nephropathy.","authors":"Hiroki Adachi,&nbsp;Norifumi Hayashi,&nbsp;Hitoshi Yokoyama","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 5","pages":"632-7"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36676109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of medullary cystic kidney disease with rapid progressive renal dysfunction and kidney enlargement.","authors":"Nobuyuki Amemiya,&nbsp;Hidekazu Sugiura,&nbsp;Takahiro Kamiyama,&nbsp;Masamitsu Ubukata,&nbsp;Hirohiko Nokiba,&nbsp;Mayuko Yamazaki,&nbsp;Takashi Takei,&nbsp;Kazuho Honda,&nbsp;Kosaku Nitta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medullary cystic kidney disease (MCKD) is usually associated with slowly progressive kidney injury. However, we encountered a case of MCKD with rapidly progressive kidney injury and irreversible renal dysfunction. A 63-year-old woman presented with a 4-month history of hypertension and rapidly progressive renal dysfunction. On admission, her blood pressure was slightly elevated (158/85 mmHg). The scrum creatinine (11.57 mg/dL) was markedly elevated. Urinalysis showed occult hematuria and proteinuria(1.06 g/gCr). /β2- microglobulin 45,000 μg/ L, N-acetyl-/β-D-glucosaminidase 5.6 U/L. Neither ultrasonography nor computed tomography revealed any evidence of renal medullary cysts. Both kidneys showed an irregular surface and enlargement. Microscopic evaluation of the renal biopsy revealed extensive tubular dilatation and atrophy with interstitial fibrosis. Often glomeruli, one had global sclerosis and the others were normal. The tubular dilatation was more marked in the distal than in the proximal tubules, according to the immunohistochemical findings of positivity for epithelial membrane antigen (EMA), a marker of distal tubules, and negativity for CD 10, a marker of proximal tubules. No immunoglobulin or complement deposition was detected in either the glomeruli or the tubules. Electron microscopy revealed disintegration of the tubular basement membrane with fragile thinning and lamination of the membrane. These pathological findings were compatible with MCKD. This was a case of MCKD diagnosed incidentally in an elderly patient who presented with rapidly progressive kidney injury accompanied by hypertension. Renal biopsy was necessary for the diagnosis.</p>","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 5","pages":"660-7"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36676114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of right femoral artery thromboembolism in steroid-dependent nephrotic syndrome].","authors":"Shohei Fukunaga,&nbsp;Kei Matsumoto,&nbsp;Yudo Tanno,&nbsp;Ko Sudo,&nbsp;Genta Uehara,&nbsp;Hitoshi Miyasato,&nbsp;Nobuo Tsuboi,&nbsp;Makoto Ogura,&nbsp;Takashi Yokoo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 37-year-old man diagnosed with minimal change nephrotic syndrome at the age of 17, was admitted to hospital with leg pain. He had relapsed nephrotic syndrome and thromboembolism of the right femoral and middle cerebral arteries. He was treated with steroid pulse therapy and thrombectomy. Right lower extremity necrosis developed and a below-knee amputation was performed. His nephrotic syndrome and the amputated lower extremity necrosis subsequently improved. Arterial thrombosis is a rare complication of nephrotic syndrome; however, it is a severe complication. Prophylactic anticoagulation should be considered in patients with an increased risk of thrombosis.</p>","PeriodicalId":19721,"journal":{"name":"Nihon Jinzo Gakkai shi","volume":"58 4","pages":"604-9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34669108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}