Researchers Database

takeda shinichi

    InternalMedicineNephrology Associate Professor
Last Updated :2021/10/19

Researcher Information

URL

J-Global ID

Research Interests

  • 細胞   移植・再生医療   移植   再生医療   細胞・組織   組織   

Research Areas

  • Life sciences / Nephrology

Academic & Professional Experience

  • 2007 - 2008  Jichi Medical UniversitySchool of Medicine助教

MISC

  • Osamu Saito, Yuki Yanaka, Takako Saito, Shinichi Takeda, Chiharu Ito, Nobuhiro Sasaki, Yasuhiro Ando, Eiji Kusano  Jichi Medical University journal  34-  1  -10  2012/03  [Not refereed][Not invited]
     
    Background: It is well known that type 2 diabetic patients easily have bone fracture regardless of normal-high bone mineral density. Otherwise, diabetic hemodialysis patients often have adynamic bone disease, but the precise mechanism underlying this disease remains unclear. Recently, osteoprotegerin (OPG) has been identified as a cytokine that inhibits osteoclast differentiation. The present study was undertaken to evaluate changes in serum OPG and other bone turnover markers in type 2 diabetic hemodialysis patients. We also evaluated the effect of type 2 diabetic change for mineral and bone disorder in hemodialysis patients. Methods: The subjects were 18 diabetic patients and 34 non-diabetic patients who were receiving hemodialysis. All patients were male. Bone turnover markers, including serum OPG, intact osteocalcin (OC), intact parathyroid hormone (iPTH), tartrate-resistant acid phosphatase (TRAP), and alkaline phosphatase activity (ALP) were measured, and bone volume was determined as the speed of sound (SOS) in the calcaneus by quantitative heel ultrasound. Results: The SOS value in diabetic patients was significantly smaller than that in non-diabetic patients. The serum OPG level in diabetic patients was significantly higher than that in non-diabetic patients, whereas serum iPTH, OC (a marker of bone formation) and TRAP (a marker of bone resorption) were significantly lower in diabetic patients. There were no significant differences in serum ALP, adjusted calcium, phosphate, and aluminum levels between the two groups. Conclusion: Type 2 diabetic hemodialysis patients have low bone volume regardless of high levels of OPG and low levels of serum iPTH, OC, and TRAP. These findings suggest type 2 diabetes is a major factor which influence mineral and bone disorder in hemodialysis patients and the effect for bone might be different from the effect under normal kidney function.
  • KOTODA Atsushi, KATO Maki, AKIMOTO Tetsu, TAKAHASHI Hideaki, ITO Chiharu, TAKEDA Shinichi, ANDO Yasuhiro, MUTO Shigeaki, YUMURA Wako, KUSANO Eiji  Nihon Toseki Igakkai Zasshi  42-  (8)  587  -593  2009/08  [Not refereed][Not invited]
     
    Heparin-induced thrombocytopenia (HIT) is a relatively common complication of heparin treatment among the patients who are newly treated by hemodialysis. We herein describe an 81-year-old woman with polycythemia vera (PV) who developed HIT associated with respiratory failure. She developed uremia due to diabetic nephropathy and hemodialysis was therefore initiated. Ten days after the first hemodialysis session, an arteriovenous fistula was surgically created to provide permanent access to the blood stream. Several minutes after the intravenous infusion of unfractionated heparin during surgery, the patient developed chest pain and became tachypenic. Thereafter, diagnostic computed tomography demonstrated the presence of thrombus, which had formed around the catheter for hemodialysis and also a right kidney infarction. However, there were no signs of any pulmonary embolism, and the presence of platelet-activating antibodies that recognize the complexes of platelet factor 4 and heparin was serologically confirmed. We therefore discontinued heparin and initiated the administration of argatroban followed by the normalization of the depleted platelet count, and the patient's respiratory symptoms finally subsided. We attributed the sustained respiratory symptoms observed in our patient to a pseudopulmonary embolism that might have resulted from a microembolism of pulmonary capillaries. We must therefore always bear in mind that the development of respiratory symptoms may be associated with the onset of HIT in patients treated with heparin. In our patient, the role that PV may have played in the clinical course of HIT remains to be elucidated. However, the identification of PV among patients with end stage renal failure may facilitate the diagnosis of thrombotic disorders including HIT, since the combination of HIT and PV is not so exceptionally rare in clinical settings.
  • Nobuhiro Sasaki, Shinichi Takeda, Takako Saito, Yasuhiro Ando, Eiji Kusano  Japanese Journal of Nephrology  51-  (4)  476  -483  2009  [Not refereed][Not invited]
     
    Purpose : Metabolic syndrome (Met S) is one of the risk factors of atherosclerotic vascular diseases related to visceral fat accumulation. However, it is well known that morbidity and mortality of hemodialysis (HD) patients are associated with malnutrition and emaciation rather than obesity, representing "reverse epidemiology". The risk of visceral fat accumulation or Met S in HD patients remains unclear. Therefore, we evaluated atherosclerosis and Met S in HD patients using various markers of obesity by means of bioelectrical impedance analysis (BIA) and brachial-ankle PWV (baPWV). Methods : The subjects comprised 52 patients who were undergoing maintenance dialysis. In addition to a general physical examination and routine blood tests, immunoreactive insulin (IRI), homeostasis model assessment for insulin resistance (HOMA-R), serum adiponectin (ADPN) and C-reactive protein (CRP) were measured before dialysis. Furthermore, we measured various body fluid components, such as the ratio of extracellular water to total body water (ECW/TBW), body fat mass (BFM), percent body fat (PBF) and visceral fat accumulation (BIA-VFA), using a body composition analyzer (InBody S20) and baPWV as a marker of atherosclerosis. Results : There was no significant difference between HD patients with and without Met S for baPWV. baPWV was positively correlated with age, systolic BP and ECW/TBW, and negatively correlated with serum albumin level, BMI and serum ADPN. However, no significant correlations were observed between baPWV and the durations of HD, Ca x P product, BIA-VFA, PBF, HOMA-R and CRP. The serum ADPN level was significantly lower in Met S than in non-Met S. In addition, the ADPN level was positively correlated with HDL-cholesterol, and negatively correlated with TG, HbA1c, CRP and various markers of obesity (Waist, BIA-VFA, BFM and PBF). In a multiple regression analysis for baPWV, the ECW/TBW ratio and serum ADPN level, as well as age and systolic BP, were independent predictors for the enhancement of baPWV in RD patients. Conclusion : The present study demonstrated that the ECW/TBW ratio and low serum ADPN level, but not Met S or obesity, could be risk factors for the acceleration of atherosclerosis in HD patients. In addition, the results showed that the relationship between ADPN, as an anti-atherosclerotic factor, and body fat or lipid metabolism were also maintained in HD patients.
  • SASAKI Nobuhiro, UENO Koushi, SHIRAISHI Takeshi, YOSHIMURA Akio, KUNO Munehiro, TAKEDA Shinichi, SAITOU Takako, ANDOU Yasuhiro, KUSANO Eiji  Nihon Toseki Igakkai Zasshi  41-  (10)  723  -730  2008/10  [Not refereed][Not invited]
     
    Recently, we have reported that bioelectrical impedance analysis (BIA) using a body composition analyzer (InBody S20) is useful for assessing the body fluid components of hemodialysis patients. The ratio of extracellular water (ECW) to total body water (TBW) appears to be a useful marker for estimating clinical dry weight (Cl-DW). The present study investigated the optimal ECW/TBW ratio for setting DW under various clinical conditions such as diabetes, heart failure, hypoalbuminemia, dialysis-related hypotension, obesity, long-term dialysis, and non-oliguric HD patients. The subjects comprised 57 patients who were undergoing maintenance dialysis. In addition to routine blood test, various body fluid components using an InBody S20 were measured before and after dialysis. Furthermore, we measured the cardiothoracic ratio (CTR) on chest Xp, and human atrial natriuretic peptide (hANP), brain natriuretic peptide (BNP), the inferior vena cava (IVC) diameter and the left ventricular ejection fraction (EF) on cardiac ultrasonography after dialysis. The ECW/TBW ratio significantly decreased after dialysis under all clinical conditions (p<0.0001). The post-dialysis ECW/TBW ratio was negatively correlated with the serum albumin concentration (r=-0.720, p<0.0001), and it was higher in diabetic patients than in non-diabetic patients (p<0.0001). Thus, we divided the patients into 4 groups based on the presence or absence of diabetes (DM) and hypoalbuminemia (hypo Alb). The post-dialysis ECW/TBW ratio was significantly higher in GroupII (DM (-), hypo Alb (+) ; 0.397±0.013, p<0.001) and GroupIII (DM (+), hypo Alb (-) ; 0.398±0.011, p<0.001), compared to that in GroupI (DM (-), hypo Alb (-) ; 0.384±0.005). The highest value was obtained from GroupIV (DM(+), hypo Alb(+) ; 0.404±0.012, p<0.0001 vs. GroupI). There was a strong positive correlation between BIA-DW, which is equal to the BW when the ECW/TBW ratio is 0.380, and Cl-DW (r=0.996, p<0.0001). These values were almost identical in GroupI. On the contrary, Cl-DW was approximately 0.5~0.8kg greater than BIA-DW in GroupII and GroupIII, and approximately 1kg greater in GroupIV. The post-dialysis ECW/TBW ratio did not correlate with blood pressure, heart function, duration of dialysis or urinary volume. In conclusion, the post-dialysis ECW/TBW ratio determined by BIA may be a useful marker for predicting DW in hemodialysis patients with various clinical backgrounds.
  • SASAKI Nobuhiro, YOSHIMURA Akio, TAKEDA Shinichi, SAITOU Takako, KUNO Munehiro, ANDO Yasuhiro, KASANO Eiji  肥満研究 : 日本肥満学会誌 = Journal of Japan Society for the Study of Obesity  14-  (1)  10  -16  2008/04  [Not refereed][Not invited]
  • TAKEDA Shin-ichi, MIYATA Yukio, MUTO Shigeaki, ASAKURA Shinji, ASANO Yasushi, OCHI Masanori, TOKUE Akihiko, KUSANO Eiji  Journal of Japanese Society for Dialysis Therapy  39-  (11)  1525  -1529  2006/11  [Not refereed][Not invited]
  • 清水 尚, 高橋 将文, 武田 真一, 田原 和典, 井上 成一朗, 吉野 浩之, 佐藤 友紀, 袴田 陽二, 金子 隆志, 竹吉 泉, 森下 靖雄, 小林 英司  日本外科学会雑誌  104-  (0)  2003/04  [Not refereed][Not invited]
  • TAKEDA Shinichi, SASAKI Nobuhiro, ITO Chiharu, NOZAKI Hiromi, INOUE Makoto, MASUNAGA Yoshinori, TAKANO Ryuichi, IIMURA Osamu, ANDO Yasuhiro, KUSANO Eiji, ASANO Yasushi  日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy  35-  (4)  243  -248  2002/04  [Not refereed][Not invited]


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