医療科学部

nakai shigeru

  (中井 滋)

Profile Information

Affiliation
School of Health Sciences Faculty of Clinical Engineering, Fujita Health University
Degree
博士(医学)

J-GLOBAL ID
201501011162251447
researchmap Member ID
7000013059

Misc.

 65
  • Kunihiro Yamagata, Takashi Yagisawa, Shigeru Nakai, Masaaki Nakayama, Enyu Imai, Motoshi Hattori, Kunitoshi Iseki, Takashi Akiba
    CLINICAL AND EXPERIMENTAL NEPHROLOGY, 19(1) 54-64, Feb, 2015  
    The prevalence and incidence of end-stage kidney disease (ESKD) have continued to increase worldwide. Japan was known as having the highest prevalence of ESKD in the world; however, Taiwan took this place in 2001, with the USA still in third position. However, the prevalence data from Japan and Taiwan consisted of dialysis patients only. The prevalence and incidence of Kidney Transplantation (KT) in Japan were quite low, and the number of KT patients among those with ESKD was regarded as negligibly small. However, the number of KT recipients has increased recently. Furthermore, there are no reports about nationwide surveys on the prevalence and incidence of predialysis chronic kidney failure patients in Japan. This review describes our recent study on the estimated number of chronic kidney disease (CKD) stage G5 patients and the number of ESKD patients living in Japan, obtained via the cooperation of five related medical societies. From the results, as of Dec 31, 2007, 275,242 patients had received dialysis therapy and 10,013 patients had a functional transplanted kidney, and as of Dec 31, 2008, 286,406 patients had received dialysis therapy and 11,157 patients had a functional transplanted kidney. Consequently, there were 285,255 patients with CKD who reached ESKD and were living in Japan in 2008 and 297,563 in 2009. We also estimated that there were 67,000 predialysis CKD stage G5 patients in 2009, 37,365 patients introduced to dialysis therapy, and 101 patients who received pre-emptive renal transplantation in this year. In total, there were 37,466 patients who newly required renal replacement therapy (RRT) in 2009. Not only the average ages, but also the primary renal diseases of the new ESKD patients in each RRT modality were different.
  • 中井 滋
    腎と透析, 76(5) 697-700, May, 2014  
  • Hasegawa Takeshi, Nakai Shigeru, Moriishi Misaki, Ito Yasuhiko, Itami Noritomo, Masakane Ikuto, Hanafusa Norio, Taniguchi Masatomo, Hamano Takayuki, Shoji Tetsuo, Yamagata Kunihiro, Shinoda Toshio, Kazama Junichiro, Watanabe Yuzo, Shigematsu Takashi, Marubayashi Seiji, Morita Osamu, Wada Atsushi, Hashimoto Seiji, Suzuki Kazuyuki, Kimata Naoki, Wakai Kenji, Fujii Naohiko, Ogata Satoshi, Tsuchida Kenji, Nishi Hiroshi, Iseki Kunitoshi, Tsubakihara Yoshiharu, Nakamoto Hidetomo
    Journal of Japanese Society for Dialysis Therapy, 47(2) 107-117, Feb, 2014  
    In 2009, we started the peritoneal dialysis (PD) registry with the cooperation of the Japanese Society for Peritoneal Dialysis as part of the annual nationwide survey conducted at the end of each year by the Statistical Survey Committee of the Japanese Society for Dialysis Therapy. In this study, we examined the current status of PD patients on the basis of the 2012 survey results. The subjects are PD patients who lived in Japan and participated in the nationwide survey conducted at the end of 2012. Descriptive analysis was performed mainly focusing on the current status of the combined use of PD and another method such as hemodialysis (HD) or hemodiafiltration (HDF), the method of dialysate exchange, the use of an automated peritoneal dialysis (APD) machine, and the incidences of peritonitis and catheter exit-site infection. From the results of the facility survey in 2012, the number of PD patients was 9,514, a decrease of 128 from that in 2011. The percentage of PD patients with respect to all the dialysis patients was 3.1%, a decrease of 0.1%. Among the PD patients, 347 did not undergo PD despite having a peritoneal lavage catheter, 175 were started on PD in 2012 but introduced to other blood purification methods in 2012, and 1,932 underwent both PD and another method such as HD or HDF (PD+HD combination therapy). The percentage of patients who underwent PD+HD combination therapy increased with the number of years on PD (PD period): less than 1 year, 4.8%; 1-2 years, 9.2% ; 2-4 years, 16.3% ; 4-8 years, 32.0% ; and 8 years or longer, 47.5%. The percentage of PD patients for which the dialysate was completely manually exchanged was 29.8%, whereas the percentages of PD patients who used a bag-exchange device based on ultraviolet-light irradiation and thermal sterile joint systems were 54.7 and 13.9%, respectively. The percentage of PD patients who used an APD machine was 43.4% with respect to the PD patients with a PD period of less than one year ; this decreased with increasing PD period beyond two years. The mean incidences of peritonitis and catheter-exit-site infection were 0.22 and 0.36 per patient per year, respectively.
  • Nakai Shigeru
    Nihon Toseki Igakkai Zasshi, 47(1) 1-56, Jan, 2014  
    A nationwide statistical survey of 4,279 dialysis facilities was conducted at the end of 2012, among which 4,238 responded (99.0%). The number of new dialysis patients was 38,055 in 2012. Since 2008, the number of new dialysis patients has remained almost the same without any marked increase or decrease. The number of dialysis patients who died in 2012 was 30,710, a slight decrease from that in 2011 (30,743). The dialysis patient population has been growing every year in Japan ; it was 310,007 at the end of 2012, which exceeded 310,000 for the first time. The number of dialysis patients per million at the end of 2012 was 2,431.2. The crude death rate of dialysis patients in 2012 was 10.0%, a slight decrease from that in 2011 (10.2%). The mean age of new dialysis patients was 68.5 years and the mean age of the entire dialysis patient population was 66.9 years. The most common primary cause of renal failure among new dialysis patients was diabetic nephropathy (44.2%). The actual number of new dialysis patients with diabetic nephropathy has been approximately 16,000 for the last few years. Diabetic nephropathy was also the most common primary disease among the entire dialysis patient population (37.1%), followed by chronic glomerulonephritis (33.6%). The percentage of dialysis patients with diabetic nephropathy has been continuously increasing, whereas not only the percentage but also the actual number of dialysis patients with chronic glomerulonephritis has decreased. The number of patients who underwent hemodiafiltration (HDF) at the end of 2012 was 21,725, a marked increase from that in 2011 (14,115). In particular, the number of patients who underwent online HDF increased threefold from 4,890 in 2011 to 14,069 in 2012. From the results of the facility survey, the number of patients who underwent peritoneal dialysis (PD) was 9,514 and that of patients who did not undergo PD despite having a PD catheter in the abdominal cavity was 347. From the results of the patient survey, among the PD patients, 1,932 also underwent another dialysis method using extracorporeal circulation, such as hemodialysis (HD) and HDF. The number of patients who underwent HD at home in 2012 was 393, a marked increase from that in 2011 (327).
  • Junichi Hoshino, Kunihiro Yamagata, Shinichi Nishi, Shigeru Nakai, Ikuto Masakane, Kunitoshi Iseki, Yoshiharu Tsubakihara
    AMERICAN JOURNAL OF NEPHROLOGY, 39(5) 449-458, 2014  
    Background/Aims: This study aims to identify current risk factors for developing dialysis-related amyloidosis using carpal tunnel syndrome (CTS) as proxy for general amyloidosis. Methods: The cohort consisted of 166,237 patients on dialysis (mean age 66.1 +/- 12.4 years; mean dialysis vintage 7.2 +/- 6.4 years) who could be followed for a year between 2010 and 2011. Of these, 2,157(1.30%) needed first-time CTS surgery during the study period. Odds ratios (ORs) for CTS were calculated at a 95% confidence interval (95% Cl) after adjusting for age, gender, primary kidney disease, history of smoking, history of hypertension vintage, dialysis modality, use of high-flux membrane, body mass index, serum albumin, Kt/V, normalized protein catabolic rate, C-reactive protein, pretreatment beta(2)-microglobulin (beta(2)MG), and beta(2)MG clearance. Results: Adjusted ORs of first-time CTS for vintages 10-15, 15-20, 20-25 (referent), 25-30, and >30 years were, respectively, 0.18 (0.12-0.26), 0.43 (0.31-0.62), 1.00, 2.37 (1.64-3.40), and 3.87(2.52-5.93). Adjusted ORs for ages 40-50, 50-60 (referent), 60-70, 70-80, and >80 were 0.53 (0.30-0.94), 1.00, 1.89 (1.41-2.52), 1.52 (1.08-2.14), and 1.04 (0.60-1.80). Female gender, low serum albumin, and diabetic nephropathy were also associated with CTS. Pretreatment serum beta(2)MG and beta(2)MG clearance <80% were not significant, although beta(2)MG clearance >80% was negatively associated with CTS [OR 0.34 (0.13-0.90)]. Conclusion: ORs of first-time CTS almost doubled with every 5-year increase in dialysis vintage. ORs of CTS were highest for patients aged 60-70. Other factors associated with CTS were gender, serum albumin, and diabetic nephropathy beta(2)MG clearance >80% may decrease the incidence of CTS. (C) 2014 S. Karger AG, Basel

Books and Other Publications

 1

Presentations

 62

教育内容・方法の工夫(授業評価等を含む)

 4
  • 件名(英語)
    -
    開始年月日(英語)
    2010/04
    概要(英語)
    担当科目:臨床医学総論1(血液学,分担担当)、臨床医学総論3(代謝内分泌学)、臨床医学総論5(腎臓泌尿器学,分担担当)、臨床医学総論6(神経内科学,分担担当)、臨床医学英語(分担担当)、アセンブリ(合唱班,分担担当)
  • 件名(英語)
    -
    概要(英語)
    教科書の記載内容から臨床工学技士国家試験出題内容を考慮した参考資料を別に作り、講義を行った。
  • 件名(英語)
    -
    概要(英語)
    臨床医学総論及び臨床医学英語の講義では、講義の始めに前回講義内容に関する小テストを毎回行い、講義した知識の定着を図った。
  • 件名(英語)
    -
    概要(英語)
    定期試験不合格者に対する再試験受験者が5名以下の少数になった場合には、再試験前に該当学生を呼び出して1~2時間の個別指導を行い、再試験受験者の孤立と無気力受験の回避に努めた(再試験の個別指導を介して自分の担当科目に興味を持たせるように、マスプロ講義では難しい個々の学生の興味や学習力に合わせた指導を行った)。

作成した教科書、教材、参考書

 5
  • 件名(英語)
    -
    終了年月日(英語)
    2011/09
    概要(英語)
    臨床工学技士国家試験の過去の出題内容に基づいた受験参考書「臨床工学入門」の一部を執筆した ("臨床医学総論" の "1.内科学概論","3.呼吸器","5.内分泌代謝系","8.腎臓泌尿器系","9.消化器系")。
  • 件名(英語)
    -
    終了年月日(英語)
    2012/07
    概要(英語)
    最新の臨床工学技士国家試験である第25回国家試験出題内容を解説した「臨床工学技士国家試験対策資料 -臨床工学入門 追補(1)-」の一部を執筆した ("臨床医学総論"の"呼吸器","循環器","代謝内分泌","神経","腎臓泌尿器","消化器",血液","救急集中治療")。
  • 件名(英語)
    -
    終了年月日(英語)
    2013/01
    概要(英語)
    臨床工学技士国家試験の過去の出題内容に基づいた受験参考書「臨床工学入門 2013年版」の一部を執筆した ("臨床医学総論" の "1.内科学概論","3.呼吸器","5.内分泌代謝系","8.腎臓泌尿器系","9.消化器系")。
  • 件名(英語)
    -
    終了年月日(英語)
    2013/07
    概要(英語)
    最新の臨床工学技士国家試験である第26回国家試験出題内容を解説した「臨床工学技士国家試験対策資料 -臨床工学入門 追補-」の一部を執筆した ("臨床医学総論"の"呼吸器","循環器","代謝内分泌","神経","腎臓泌尿器","消化器",血液","救急集中治療")。
  • 件名(英語)
    -
    終了年月日(英語)
    2014/01
    概要(英語)
    臨床工学技士国家試験の過去の出題内容に基づいた受験参考書「臨床工学入門 2014年版」の一部を執筆した ("臨床医学総論" の "1.内科学概論","3.呼吸器","5.内分泌代謝系","8.腎臓泌尿器系","9.消化器系")。