基本情報
研究分野
1経歴
3-
2018年4月 - 現在
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2012年11月 - 2018年3月
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2007年7月 - 2012年10月
論文
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Drug Target Insights 9 29-31 2015年11月11日 査読有りA 48-year-old female was admitted to our hospital presenting with a chief complaint of progressive swelling because of diabetic nephrotic syndrome. Dapagliflozin seemed to play a role in accelerating the patient’s urinary sodium excretion as well as reducing gross fluid retention despite the fact that her nephrotic condition was resistant to furosemide. Our experience emphasizes a potential novel approach to overcoming loop diuretic resistance using this agent among some subsets of type 2 diabetic subjects complicated with severe volume accumulation. We believe that combination treatment consisting of dapagliflozin and furosemide may produce diuretic synergy via sequential nephron blockade. The accumulation of more experience with additional cases similar to ours requires continuous and careful attention.
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Clinical Medicine Insights: Case Reports 8 97-100 2015年9月27日 査読有りIn this report, we describe the case of an end-stage kidney disease patient with tetralogy of Fallot (TOF). A 33-year-old female with TOF was admitted to our hospital with complaints of general fatigue and appetite loss probably due to uremic milieu. She was ultimately treated with peritoneal dialysis (PD) with a favorable clinical course. TOF patients with chronic kidney disease are not exceptional, although the currently available information regarding the association between TOF and renal failure severe enough to require dialysis treatment is limited. We also discuss the complex processes of how and why PD was selected as a mode of chronic renal replacement therapy in this case.
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Clinical Medicine Insights: Case Reports 6 171-175 2013年11月25日 査読有りAn autogenous arteriovenous fistula has been considered to be the optimal form of vascular access for hemodialysis (HD) in the field of nephrology. Nevertheless, the decision regarding the type of access, whether it be an arteriovenous fistula, an arteriovenous graft, or a central venous cath-eter, must still be individualized. In the present report, we describe the case of a female patient with advanced chronic kidney disease (CKD) associated with a hemostatic disorder. Despite the exhausted peripheral vasculature, she required recurrent platelet transfusions for severe thrombocytopenia due to aplastic anemia. The goal of care for this patient was to optimize the dialysis treatment without increasing the bleeding risk. Various concerns regarding the therapeutic conundrums encountered in the case are also discussed. © the authors, publisher and licensee Libertas Academica Limited.
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Internal medicine (Tokyo, Japan) 52(18) 2087-91 2013年We herein report the case of a 17-year-old man who developed an increased plasma creatinine level (11.1 mg/dL) and oliguria with massive proteinuria (27.3 g/day) four weeks after an abraded wound to his right knee. The histology of the renal biopsy specimens showed diffuse endocapillary proliferative glomerulonephritis with the deposition of nephritis-associated plasmin receptor in the glomerulus. A case of acute kidney injury due to nephrotic syndrome caused by acute post-streptococcal glomerulonephritis was diagnosed. His renal function and proteinuria were improved with supportive care, including hemodialysis, without the administration of immunosuppressive agents.
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Internal Medicine 50(1) 47-51 2011年Paraneoplastic nephropathy is a rare complication of malignant disease. We present a case of cervical cancer with biopsy-proven membranous nephropathy and associated nephrotic syndrome. Irradiation to the specific neoplasm site and to the metastatic paraaortic lymph node tissues lead to regression of the nephrotic syndrome without causing severe adverse events. Radiation therapy can be the first choice in the treatment of paraneoplastic nephrotic syndrome if the primary neoplasm is unresectable. Invasiveness of intervention and patient prognosis should be carefully deliberated in the management of the two diseases.<br>
MISC
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The Japanese journal of nephrology = 日本腎臓学会誌 57(7) 1233-1240 2015年
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自治医科大学紀要 = Jichi Medical University Journal 35 1-6 2013年3月Background： In hemodialysis patients, failure of arteriovenous fistula（ AVF） is a serious problem. AVFstenosis is dominant cause of vascular access failure. We hypothesized that vascular endothelial damage maybe involved in arteriovenous fistula（ AVF） stenosis.Methods： A cross-sectional observational survey was performed in 122 patients receiving maintenancehemodialysis in January - April 2004. Serum levels of adiponectin, adhesion molecules（ intercellular adhesionmolecule-1； ICAM-1 and vascular cell adhesion molecule-1； VCAM-1）, and endothelial injury markers（CD146 and thrombomodulin） were compared between 46 patients with AVF stenosis and 76 patientswithout AVF stenosis to determine factors associated with AVF stenosis.Results： The serum adiponectin level was significantly lower in patients with AVF stenosis compared tothose without AVF stenosis. Similarly, the serum levels of ICAM-1 and thrombomodulin were significantlylower in patients with AVF stenosis, whereas the serum level of VCAM-1 was significantly higher in patientswith AVF stenosis. There were no significant differences in other parameters between the two groups.Logistic regression analysis with the presence or absence of AVF stenosis as the dependent variable showedthat administration of an antihypertensive drug, VCAM-1, ICAM-1 and thrombomodulin were significantlyassociated with the presence of AVF stenosis in hemodialysis patients.Conclusion： The significant associations of administration of an antihypertensive drug, VCAM-1, ICAM-1 and thrombomodulin with AVF stenosis suggest that endothelial injury may play a critical role in thiscondition.
共同研究・競争的資金等の研究課題
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日本学術振興会 科学研究費助成事業 2004年 - 2006年