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Clinical and Experimental Nephrology

Kazuya Matsumura, Yohei Matsuzaki, Mariko Hida, Kazushige Ikeda, Midori Awazu
BACKGROUND: Extremely low birth weight (ELBW) survivors may develop glomerulosclerosis due to low nephron number, whereas their tubular function remains unknown except for hypercalciuria and phosphaturia. METHODS: Fifty-three subjects (30 boys and 23 girls, aged 7 months-19 years, median 36 months) were studied retrospectively. The median gestational age and birth weight were 26 weeks (range 22-32) and 745 g (range 316-999), respectively. Urine calcium-to-creatinine ratio (Ca/Cr), N-acetyl-β-D-glucosaminidase-to-creatinine ratio (NAG/Cr), β2 microglobulin-to-creatinine ratio (β2m/Cr), uric acid-to-creatinine ratio (UA/Cr), glucose-to-creatinine ratio (glu/Cr), and microalbumin-to-creatinine ratio (malb/Cr) were examined...
September 20, 2018: Clinical and Experimental Nephrology
Bartłomiej Matłosz, Ewa Pietraszkiewicz, Ewa Firląg-Burkacka, Ewa Grycner, Andrzej Horban, Justyna D Kowalska
BACKGROUND: Kidney injury is a serious comorbidity among HIV-infected patients. Intravenous drug use is listed as one of the risk factors for impaired renal function; however, this group is rarely assessed for specific renal-related risks. METHODS: Patients attending methadone program from 1994 to 2015 were included in the study. Data collected included demographic data, laboratory tests, antiretroviral treatment history, methadone dosing and drug abstinence. Patients' drug abstinence was checked monthly on personnel demand...
September 14, 2018: Clinical and Experimental Nephrology
Toshijiro Aoki, Hideki Ishii, Akihito Tanaka, Susumu Suzuki, Satoshi Ichimiya, Masaaki Kanashiro, Toyoaki Murohara
BACKGROUND: The combined influence of CKD and worsening renal function (WRF) on clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has not been fully understood. METHODS: We analyzed 443 patients diagnosed with AMI who underwent primary PCI. Based on their estimated glomerular filtration rate (eGFR), they were classified into two groups: a high eGFR group (eGFR ≥ 45 mL/min/1.73 m2 , n = 381) and a low eGFR group (eGFR < 45 mL/min/1...
September 14, 2018: Clinical and Experimental Nephrology
Shun Kubo, Masaki Iwasaki, Mari Horie, Ai Matsukane, Toshihide Hayashi, Yuri Tanaka, Hiroki Hase, Nobuhiko Joki
BACKGROUND: There is no obvious evidence regarding biological variation of procalcitonin (PCT) levels in hemodialysis (HD) patients without infections. The aim of this study was to determine the within- and between-person biological variation of PCT levels in HD patients without infections. METHODS: A multicenter, prospective, cohort study enrolled 123 HD patients without any signs of infectious disease. Baseline PCT levels were determined pre- and post-HD, and then repeated pre-HD PCT measurements were performed at 2, 4, 8, 12, 16, 20, and 24 weeks after baseline blood-sampling, regardless of the presence or absence of infectious disease...
September 8, 2018: Clinical and Experimental Nephrology
Yosuke Mitsui, Takuya Sadahira, Motoo Araki, Yuki Maruyama, Koichiro Wada, Ryuta Tanimoto, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu
BACKGROUND: Excessive visceral fat may decrease renal function because of metabolic derangements. The aim of this study was to evaluate the impact of abdominal fat distribution on renal function of recipients after kidney transplantation using the visceral adipose tissue (VAT)/subcutaneous adipose tissue (SAT) ratio. METHODS: Seventy-nine patients underwent living kidney transplantation from 2009 to 2017. Patients without a correct measurement of VAT and SAT, follow-up of < 6 months, or with kidney transplant rejection or a virus infection were excluded...
September 6, 2018: Clinical and Experimental Nephrology
Tetsuhiro Tanaka, Masaomi Nangaku, Enyu Imai, Yoshiharu Tsubakihara, Masatoshi Kamai, Michihito Wada, Shinji Asada, Tadao Akizawa
BACKGROUND: This post-marketing surveillance (PMS) study evaluated the safety and effectiveness of long-term darbepoetin alfa (darbepoetin) for the treatment of renal anemia in Japanese non-dialysis chronic kidney disease patients. METHODS: Patients were treated with darbepoetin and followed up for 3 years. Adverse events (AEs), adverse drug reactions (ADRs), hemoglobin (Hb) levels, and renal function were assessed. Patients were stratified by Hb level at the time of occurrence of cardiovascular-related AEs...
September 4, 2018: Clinical and Experimental Nephrology
Daisuke Takada, Junichi Hoshino, Takayuki Fujii, Joichi Usui, Takeshi Fujii, Kenichi Ohashi, Kenmei Takaichi, Satoshi Suzuki, Kunihiro Yamagata, Yoshifumi Ubara
BACKGROUND: Tonsillectomy performed on patients with Immunoglobulin A glomerulonephritis (IgAN) improved the clinical remission rate as defined by urinary protein. But the number of times steroid pulse therapies (SP) should be administered remained poorly understood. METHOD: Multicenter, observational, retrospective cohort study at four hospitals in the Tokyo metropolitan area between March 1981 and December 2013. We divided patients into two groups: those treated with SP three times and those treated without SP or with SP only once or twice, and we analyzed standard Cox proportional hazard model unadjusted and adjusted the confounding covariates to estimate the hazard ratio for the primary outcome, the 30% estimated decline in glomerular filtration rate, in four models: model 1, unadjusted; model 2, adjusted for age, sex, body mass index, estimated glomerular filtration rate, biopsy year, proteinuria, hematuria, Japanese historical grade, systolic blood pressure, smoking history, and diabetes as a comorbidity; model 3, adjusted for propensity score, which was estimated by multiple logistic regressions; model 4, multilevel mixed-effects parametric survival models, whose facilities comprise the second level...
September 3, 2018: Clinical and Experimental Nephrology
Chia-Lin Shen, Chin-Chen Pan, Chih-Yu Yang
We report a lady with bilateral symmetrical xanthogranulomatous pyelonephritis (XPGN) presented with acute kidney injury and sepsis, in which both CT and MRI mimicked an infiltrative disease, except that the infiltration was not very homogenous. Eventually, the pathological diagnosis turned out to be XPGN. Most XPGN were unilateral, and there have been a few publications of bilateral involvement. Moreover, this case lacked typical manifestations, such as renal calculus, contracted renal pelvis, or obstructive nephropathy...
September 3, 2018: Clinical and Experimental Nephrology
Junichi Ishigami, Kunihiro Matsushita
Infectious disease is recognized as an important complication among patients with end-stage renal disease, contributing to excess morbidity and health care costs. However, recent epidemiological studies have revealed that even mild to moderate stages of chronic kidney disease (CKD) substantially increase risk of infection. Regarding underlying mechanisms, evidence suggests various aspects of altered immune response in patients with CKD including impaired function of T cells, B cells and neutrophil. Multiple conditions surrounding CKD, such as older age, diabetes, and cardiovascular disease are important contributors in the increased susceptibility to infection in this population...
September 3, 2018: Clinical and Experimental Nephrology
Hideaki Oka, Shunsuke Yamada, Taro Kamimura, Atsumi Harada, Kazuhiko Tsuruya, Toshiaki Nakano, Takanari Kitazono
BACKGROUND: Acute kidney injury (AKI) is one of the most severe complications after cardiothoracic surgery (CTS). However, diagnosis of AKI by elevation of serum creatinine (SCr) misses a critical time period for prevention and treatment of AKI. We have observed that patients who develop AKI show a smaller SCr decrease after CTS than those without AKI. Hence, we hypothesized that the magnitude of the SCr change (ΔSCr) measured early after CTS can predict subsequent AKI. METHODS: We conducted a retrospective analysis from January 2014 to December 2016 to examine the association of ΔSCr with AKI...
August 29, 2018: Clinical and Experimental Nephrology
Takashi Shigematsu, Ryutaro Shimazaki, Masafumi Fukagawa, Tadao Akizawa
BACKGROUND: This study investigated the pharmacokinetics, pharmacodynamics, and safety of multiple doses of evocalcet in Japanese secondary hyperparathyroidism (SHPT) patients receiving hemodialysis. METHODS: In this multicenter, open-label study, conducted between August 2013 and March 2014, 27 patients received multiple doses of 1 and 4 mg evocalcet for 14 days, followed by an extension period of multiple doses of 8 and 12 mg evocalcet for 7 days using an intra-patient dose escalation protocol...
August 29, 2018: Clinical and Experimental Nephrology
Hideyo Oguchi, Makoto Tsujita, Masahiko Yazawa, Takehiko Kawaguchi, Junichi Hoshino, Masahiro Kohzuki, Osamu Ito, Kunihiro Yamagata, Yugo Shibagaki, Tadashi Sofue
BACKGROUND: The effectiveness of exercise in kidney transplant recipients is not well established. We, therefore, performed a systematic review of the effects of exercise training in kidney transplantation recipients. METHODS: We searched two electronic databases for articles up to April 2017. Inclusion criteria were as follows: randomized controlled trial and kidney transplant recipients aged 18 years or older. The main outcomes were allograft function (estimated glomerular filtration rate, eGFR), exercise tolerance (VO2 peak), and quality of life (QOL)...
August 24, 2018: Clinical and Experimental Nephrology
Yuichi Maruta, Takeshi Hasegawa, Etsuko Yamakoshi, Hiroki Nishiwaki, Fumihiko Koiwa, Enyu Imai, Akira Hishida
BACKGROUND: Metabolic acidosis, which reduces serum bicarbonate levels, contributes to the progression of chronic kidney disease (CKD). The difference between sodium and chloride (Na-Cl) may theoretically predict serum bicarbonate levels. This study aimed to evaluate serum Na-Cl level as a risk factor for renal function decline among patients who participated in the chronic kidney disease Japan cohort (CKD-JAC) study. METHODS: The association between low Na-Cl concentration (< 34 mmol/L) and composite renal function decline events (any initiation of renal replacement therapy or 50% decline in estimated glomerular filtration rate) was evaluated among 2143 patients with CKD stage G3a-4...
August 24, 2018: Clinical and Experimental Nephrology
Sebastian Schwab, Christian Frederic Zachoval, Dominik Bös, Christian P Strassburg, Rainer Peter Woitas
No abstract text is available yet for this article.
August 24, 2018: Clinical and Experimental Nephrology
Yoshimitsu Gotoh, Osamu Uemura, Kenji Ishikura, Tomoyuki Sakai, Yuko Hamasaki, Yoshinori Araki, Riku Hamada, Masataka Honda
In the original publication, the author name was published incorrectly as "Riku Hamda". The corrected name is given in this Correction.
August 24, 2018: Clinical and Experimental Nephrology
Hyeok Choi, Youhyun Kim, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
OBJECTIVES: We investigated whether low serum C3 level can cross-sectionally estimate severe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in immunosuppressive drug-naïve patients at diagnosis. METHODS: We retrospectively reviewed the medical records of 139 patients with AAV, who were first classified as AAV at Severance Hospital. We obtained clinical and laboratory data including serum complement 3 (C3) level and calculated Birmingham vasculitis activity score (BVAS) at diagnosis...
August 23, 2018: Clinical and Experimental Nephrology
Yasuhiro Ueda, Hayato Aoyagi, Takayuki Okamoto
Left-sided inferior vena cava (IVC) is a rare malformation of IVC. We report an 11-year-old boy with hematuria and left lower back pain due to compression of the left-sided IVC between the aorta and the superior mesenteric artery. Ultrasonography and magnetic resonance imaging clearly revealed this anatomic anomaly.
August 23, 2018: Clinical and Experimental Nephrology
Andrea Schmidts, Julian Grünewald, Martina Kleber, Evangelos Terpos, Gabriele Ihorst, Heike Reinhardt, Gerd Walz, Ralph Wäsch, Monika Engelhardt, Stefan Zschiedrich
BACKGROUND: The estimated glomerular filtration rate (eGFR) is clinically used to approximate renal function and adapt drug dosage. Multiple myeloma is a hematological disease; its prognosis is largely influenced by renal function. We evaluated two commonly used GFR estimations, CKD-EPI and MDRD (CKD Epidemiology Collaboration; Modification of Diet in Renal Disease) in myeloma patients undergoing treatment with lenalidomide, a renally excreted immunomodulatory drug. METHODS: We prospectively studied 130 myeloma patients receiving lenalidomide treatment at our institution...
August 20, 2018: Clinical and Experimental Nephrology
Kandai Nozu, Koichi Nakanishi, Yoshifusa Abe, Tomohiro Udagawa, Shinichi Okada, Takayuki Okamoto, Hiroshi Kaito, Katsuyoshi Kanemoto, Anna Kobayashi, Eriko Tanaka, Kazuki Tanaka, Taketsugu Hama, Rika Fujimaru, Saori Miwa, Tomohiko Yamamura, Natsusmi Yamamura, Tomoko Horinouchi, Shogo Minamikawa, Michio Nagata, Kazumoto Iijima
Alport syndrome (AS) is a progressive hereditary renal disease that is characterized by sensorineural hearing loss and ocular abnormalities. It is divided into three modes of inheritance, namely, X-linked Alport syndrome (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ADAS and ARAS are caused by those in COL4A3/COL4A4. Diagnosis is conventionally made pathologically, but recent advances in comprehensive genetic analysis have enabled genetic testing to be performed for the diagnosis of AS as first-line diagnosis...
August 20, 2018: Clinical and Experimental Nephrology
Takayuki Katsuno, Tomohiro Masuda, Shoji Saito, Noritoshi Kato, Takuji Ishimoto, Sawako Kato, Tomoki Kosugi, Naotake Tsuboi, Hiroshi Kitamura, Toyonori Tsuzuki, Yasuhiko Ito, Shoichi Maruyama
BACKGROUND: Recent reports have described the efficacy of rituximab in treating steroid-dependent nephrotic syndrome (SDNS) in pediatric patients. However, few reports describe data regarding adult-onset SDNS. We investigated the efficacy of rituximab for the management of adult-onset SDNS. METHODS: We performed a retrospective cohort study investigating eight patients with adult-onset SDNS who were treated with rituximab. Clinical data were obtained at the initiation of rituximab therapy...
August 18, 2018: Clinical and Experimental Nephrology
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