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後藤 公彦医学部附属病院 腎・血液浄化センター助教
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■ 論文- We present three cases of IgA nephropathy with gross hematuria following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccination. Case 1 was a 60-year-old woman who has previously experienced transient proteinuria. Case 2 was a 22-year-old woman with no history of urinary abnormality. Finally, case 3 was a 66-year-old woman who has had microscopic hematuria since she was in her 50s. They were all diagnosed as IgA nephropathy with little histological active lesion. Their renal function and proteinuria improved without the use of corticosteroids. There were differences in the findings of vascular endothelial damage based on the time between the appearance of gross hematuria and renal biopsy. Glomerular endocapillary damage could be a part of the mechanism triggered by mRNA vaccination. When a patient presents with gross hematuria following vaccination, a comprehensive approach including renal biopsy should be considered.2023年05月, CEN case reports, 12(2) (2), 176 - 183, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Nephrotic syndrome (NS) results in massive proteinuria and hypoalbuminemia, which are responsible for a compensatory increase in protein synthesis in the liver. Serum cholinesterase (ChE) also increases in NS. However, its clinical value is not fully elucidated. METHODS: In this study, 184 patients with NS who underwent kidney biopsy were included. The patients were divided into two groups according to serum ChE levels, as follows: hypercholinesterasemia (HC) and non-hypercholinesterasemia (NHC) groups. The clinical factors were compared between the two groups. RESULTS: The HC group had significantly more severe proteinuria and higher prevalence of high selective proteinuria than the NHC group. Furthermore, the prevalence of minimal change nephrotic syndrome (MCNS) was significantly higher in the HC group than that in the NHC group. Multivariate analysis revealed that the severity of proteinuria and MCNS were significantly associated with HC. CONCLUSION: In this study, HC in NS was associated with the severity of proteinuria and MCNS, and could help clinicians predict the histological diagnosis of NS.2022年04月, BMC nephrology, 23(1) (1), 128 - 128, 英語, 国際誌研究論文(学術雑誌)
- INTRODUCTION: Recent clinical studies demonstrated the favorable effects of calcium-free phosphate binders on mortality and vascular calcification in hemodialysis (HD) patients. The aim of the present study was to investigate the effects of a calcium-free phosphate binder, lanthanum carbonate (LC), on bone metabolic markers and bone mineral density (BMD), compared with those of calcium carbonate (CC), in subjects new to HD. MATERIALS AND METHODS: The present study included 65 subjects from our previous randomized controlled trial (LC group, N = 31; CC group, N = 34). We investigated the effects of LC on serum intact parathyroid hormone (iPTH), osteocalcin (OC), bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRACP-5b), sclerostin levels, and BMD, compared with those of CC in patients new to HD at baseline and at 12 and 18 months. RESULTS: Serum OC levels at 18 months were significantly higher in the LC group than in the CC group. During the study period, serum BAP and TRACP-5b and iPTH levels tended to be higher in the LC group than in the CC group. At 18 months, the percentage of low bone turnover, based on a serum BAP cutoff value, was significantly lower in the LC group than in the CC group. There were no significant differences in the lumbar and femoral BMD between the two groups. CONCLUSIONS: The results of the present study suggest that LC has potential in preventing low bone turnover, in comparison to CC, in patients new to HD.2019年11月, Journal of bone and mineral metabolism, 37(6) (6), 1075 - 1082, 英語, 国内誌研究論文(学術雑誌)
- Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is a life-threatening disease characterized by rapidly progressive glomerulonephritis (RPGN) and diffuse alveolar hemorrhage (DAH). Glucocorticoids and immunosuppressants are commonly used to treat this disease but may induce irreversible side effects, particularly in elderly patients. We herein report the case of a 76-year-old woman with RPGN. After methylprednisolone pulse therapy, DAH occurred, and she required ventilatory support. After plasma exchange, her serum creatinine level improved, and she was discharged with home oxygen therapy. Immunosuppressive agents other than glucocorticoids were not required. In conclusion, plasma exchange with glucocorticoid therapy may be effective in treating severe ANCA-associated vasculitis in elderly patients.2017年, Internal medicine (Tokyo, Japan), 56(1) (1), 55 - 59, 英語, 国内誌研究論文(学術雑誌)
- 2024年, 日本腎臓学会誌(Web), 66(6-W) (6-W)ファブリー病患者における骨密度についての知見とスクリーニングへの取り組み
- 2023年, 内科, 132(1) (1)保存期慢性腎臓病と透析期のステージに応じた診療のポイント[Chapter2]輸液・電解質異常への対応 CKDにおけるカリウム管理
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 334 - 334, 日本語ネフローゼ症候群におけるコレステロール,コリンエステラーゼの変化と臨床的特徴
- (一社)日本腎臓学会, 2019年, 日本腎臓学会誌, 61(3) (3), 422 - 422, 日本語腎移植患者と血液透析患者における腹部大動脈石灰化進展速度の比較
- 2017年, 日本内科学会雑誌, 106(4) (4)腎生検にてlight chain proximal tubulopathyと診断したFanconi症候群を伴う単クローン性γグロブリン血症の1例
- 2017年, 日本腎臓学会誌, 59(3) (3)腎臓病教育入院中のeGFRの低下と腎予後の検討
