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  2. 長谷川 みどり

長谷川 みどり

ハセガワ ミドリ  (Hasegawa Midori)

基本情報

所属
藤田医科大学 医学部 医学科 腎臓内科学 教授
学位
医学博士
J-GLOBAL ID
200901076209356036
researchmap会員ID
5000025129

研究キーワード

 9

研究分野

 1

経歴

 4

学歴

 2

委員歴

 2

受賞

 1

論文

 117
  • Taihei Ito, Takashi Kenmochi, Shinichiro Ono, Minoru Oshima, Naohiro Aida, Atsushi Suzuki, Midori Hasegawa, Mamoru Kusaka, Kiyotaka Hoshinaga
    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 23(5) 270-275 2016年5月  査読有り
    BackgroundA total of 26 pancreas transplants from brain dead donors, including 21 simultaneous pancreas and kidney (SPK) transplantation procedures, have been performed at Fujita Health University Hospital since the new pancreas transplant program was initiated in August 2012. The objective of this study is to investigate the outcomes of pancreatic transplantation in our facility in first 3 years of the program. MethodsThe background characteristics of the donors and the outcomes of 26 pancreas transplant recipients were analyzed. ResultsThe mean age of the recipients was 44.0years, and all recipients had a long-term history of diabetes (mean: 30.2years). In the SPK cases, the patients also had a long history of hemodialysis (mean: 6.3years). Although the average donor age was 41.0years and more than half of the donors were marginal donors (defined according to Kapur's criteria and Troppmann's criteria), the patient survival and pancreatic graft survival rates were 100% and 91.7%, respectively. Unfortunately, two recipients experienced graft failure due to graft thrombosis, which resulted in graft loss. ConclusionsThe new pancreas transplant program at Fujita Health University has provided excellent outcomes for patients with type 1 diabetes.
  • Takada Kayoko, Ishii Junichi, Hasegawa Midori, Okuyama Ryunosuke, Kawai Hideki, Yamada Akira, Naruse Hiroyuki, Motoyama Sadako, Matsui Shigeru, Hayashi Mutsuharu, Izawa Hideo, Yuzawa Yukio, Ozaki Yukio
    Circulation Journal 80(Suppl.I) 1377-1377 2016年3月  査読有り
  • M. Tada, M. Hasegawa, H. Sasaki, M. Kusaka, R. Shiroki, K. Hoshinaga, T. Ito, T. Kenmochi, S. Nakai, K. Takahashi, H. Hayashi, S. Koide, Y. Yuzawa
    TRANSPLANTATION PROCEEDINGS 48(1) 26-30 2016年1月  査読有り
    Background. The waiting time for deceased-donor kidney-only transplantations in Japan is long. Herein, we assessed the effect of length of dialysis on the outcomes of these patients. Methods. We divided patients into 2 groups based on length of dialysis (Group A, <15 years, and Group B, >= 15 years), and compared the background and outcomes after kidney transplantation. Results. Group A included 210 patients and Group B included 35 patients. In Group B, 20% of transplants were from living donors. Patient age (P = .017) and the hepatitis C infection rate (P = .018) were significantly higher in Group B, whereas hypertension (P = .011), diabetes (P = .041), and ABO-incompatibility rates (P = .015) were significantly higher in Group A. The 5- and 10-year survival rates were 97.0% and 95.4%, respectively, in Group A and 97.1% and 97.1%, respectively, in Group B. The 5- and 10-year graft survival rates were 95.4% and 84.8%, respectively, in Group A and 97.1% and 73.1%, respectively, in Group B. There were no significant differences between the groups in patient survival (P = .74) and graft survival (P = .72). The 5- and 10-year cardiovascular event-free survival rates were 95.9% and 92.4%, respectively, in Group A and 88.6% and 76.8%, respectively, in Group B. Cardiovascular event-free survival was significantly higher in Group A (P = .038). Cox stepwise multivariate analysis indicated that length of dialysis was a significant predictor of cardiovascular events (hazard risk, 1.007; range, 1.001-1.012; P = .012). Conclusion. The prognosis after kidney transplantation is promising even after a long length of dialysis, although evaluation of the cardiovascular risk is needed in these cases.
  • Midori Hasegawa, Kyoko Hattori, Satoshi Sugiyama, Hiroaki Asada, Hiroshi Yamashita, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Waichi Sato, Yukio Yuzawa
    MODERN RHEUMATOLOGY 26(1) 110-114 2016年1月  査読有り
    Objectives. This study investigated the clinical course of myeloperoxidase-antineutrophil cytoplasm autoantibody (MPO-ANCA)-associated vasculitis after starting dialysis.Methods. A retrospective review was conducted of the clinical charts of dialysis-dependent patients with MPO-ANCA-associated vasculitis who attended one of 8 associated clinics over the past 21 years.Results. Eighty-nine patients were included in the study; 88 had microscopic polyangiitis (MPA) and 1 had granulomatosis with polyangiitis. Of the 88 patients with MPA, 18 had renal-limited vasculitis. Twenty-one relapses occurred among 13 patients (frequency, 0.05 relapses/person-year; 95% confidence interval, 0.03-0.08). Mean time from start of dialysis to relapse was 65 59 months. Cox multivariate analysis showed that pulmonary involvement was a predictor of relapse (hazard ratio [HR], 21.4) and mortality (HR, 4.60), and that patient age (HR, 1.10) and cyclophosphamide use (HR, 0.20) were significant predictors of mortality. Postdialysis 1- and 5-year survival rates were 83.0% and 65.6%, respectively; infection was the most frequent cause of death.Conclusion. Pulmonary involvement was a predictor of relapse and mortality. Although relapse can occur long after the start of dialysis, incidence was low among dialysis-dependent patients. Prolonged maintenance immunosuppressive therapy might be limited to patients with pulmonary involvement in dialysis-dependent ANCA-associated vasculitis.
  • Tomohito Doke, Waichi Sato, Kazuo Takahashi, Hiroki Hayashi, Sigehisa Koide, Hitomi Sasaki, Mamoru Kusaka, Ryoichi Shiroki, Kiyotaka Hoshinaga, Asami Takeda, Yukio Yuzawa, Midori Hasegawa
    INTERNAL MEDICINE 55(4) 375-380 2016年  査読有り
    A 53-year-old woman who had undergone deceased donor kidney transplantation twice, at 35 and 43 years of age, presented with renal impairment. She was infected with hepatitis C virus (HCV). The histology of the graft kidney revealed post-transplant membranous nephropathy (MN) with podocytic infolding and antibody-mediated rejection (AMR). IgG subclass staining showed fine granular deposits of IgG1 and IgG3, but not IgG4, in the glomerular capillary walls. Panel reactive antibody scores for human leukocyte antigen class I and class II were 92.67% and 66.68%, respectively. Thus, this case of post-transplanted MN was considered to be associated with AMR and HCV infection.
  • Kazuyoshi Sakai, Takao Senda, Ryuji Hata, Makoto Kuroda, Midori Hasegawa, Masao Kato, Masato Abe, Kazunori Kawaguchi, Shigeru Nakai, Yoshiyuki Hiki, Yukio Yuzawa, Nobuya Kitaguchi
    JOURNAL OF ALZHEIMERS DISEASE 51(4) 997-1002 2016年  査読有り
    As a proof of concept that removal of blood amyloid-beta (A beta) can reduce A beta deposition in the brains of patients with Alzheimer's disease, cortices of patients who had undergone hemodialysis (HD), which removes A beta from the blood, were histochemically analyzed; postmortem brain sections were stained with anti-A beta antibodies. Brains from patients who had undergone HD had significantly fewer senile plaques than those of patient who had not undergone HD. This significant difference was also confirmed by silver staining. Our findings suggest that removal of blood A beta by hemodialysis results in lower accumulation of A beta in the brain.
  • Midori Hasegawa, Junichi Ishii, Fumihiko Kitagawa, Hiroshi Takahashi, Kazuhiro Sugiyama, Masashi Tada, Kyoko Kanayama, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Shigeru Nakai, Yukio Ozaki, Yukio Yuzawa
    BIOMED RESEARCH INTERNATIONAL 2016 8761475 2016年  査読有り
    Background. Our aim was to assess plasma neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of cardiovascular (CV) events in patients with chronic kidney disease (CKD) and no history of CV events. Methods. This was a prospective observational cohort study of 252 patients with predialysis CKD. CV events were defined as CV death, acute coronary syndrome, and hospitalization for worsening heart failure, stroke, and aortic dissection. Results. During a median follow-up period of 63 months, 36 CV events occurred. On Cox stepwise multivariate analysis, plasma NGAL and B-type natriuretic peptide (BNP) were significant predictors of CV events. Kaplan-Meier incidence rates of CV event-free survival at 5 years were 96.6%, 92.9%, 85.9%, and 61.3%, respectively, among quartiles of plasma NGAL (P < 0.0001). The C-index for the receiver-operating characteristic curves for CV events was greater when plasma NGAL was added to an established risk model (0.801, 95% CI 0.717-0.885), compared to the model without plasma NGAL (0.746, 95% CI 0.653-0.840, P = 0.021). Conclusion. Elevated plasma NGAL could predict future CV events in CKD patients with no history of CV events and add incremental value to the established risk model.
  • Kitaguchi N, Hasegawa M, Ito S, Kawaguchi K, Hiki Y, Nakai S, Suzuki N, Shimano Y, Ishida O, Kushimoto H, Kato M, Koide S, Kanayama K, Kato T, Ito K, Takahashi H, Mutoh T, Sugiyama S, Yuzawa Y
    Journal of neural transmission (Vienna, Austria : 1996) 122(11) 1593-1607 2015年11月  査読有り
  • 佐々木 ひと美, 鈴木 敦詞, 長谷川 みどり, 剣持 敬, 伊藤 明美, 深見 直彦, 日下 守, 星長 清隆, 白木 良一
    移植 50(総会臨時) 261-261 2015年9月  
  • Haruna Arai, Hiroki Hayashi, Kazuo Takahashi, Shigehisa Koide, Waichi Sato, Midori Hasegawa, Yutaka Yamaguchi, Jan Aten, Yasuhiko Ito, Yukio Yuzawa
    RHEUMATOLOGY INTERNATIONAL 35(6) 1093-1101 2015年6月  査読有り
    Renal parenchymal lesions in patients with IgG4-related kidney disease (IgG4-RKD) are characterized by tubulointerstitial nephritis with storiform fibrosis and infiltration by high numbers of IgG4-positive plasma cells. The aim of this study was to evaluate the clinical and pathological effects of corticosteroid therapy in patients with IgG4-RKD. Of six patients who were diagnosed with IgG4-RKD, four patients underwent re-biopsy at approximately 30-50 days after corticosteroid therapy was initiated. Based on the classification of Yamaguchi et al., the degree of tubulointerstitial fibrosis was classified before and after therapy. In addition, tubulointerstitial expression patterns of alpha-smooth muscle actin (alpha-SMA), collagen I, III, and IV protein, and connective tissue growth factor (CTGF) mRNA were examined. Histopathological findings before treatment showed alpha-SMA-positive myofibroblasts in the lesion, and CTGF mRNA-positive cells were found in the cellular infiltrate. Although corticosteroid therapy improved serum creatinine clinically, the stage of fibrosis advanced pathologically as evidenced by increased staining for collagen I and III. However, the number of IgG4-positive plasma cells decreased, and CTGF mRNA expression reduced. In other words, fibrosis had advanced from the time of extensive cell infiltration in patients with IgG4-RKD and inflammation was relieved by corticosteroid. A reduced number of positive CTGF mRNA expression cells in repeat biopsies indicated that the fibrosis process was terminated by corticosteroid therapy. We propose that corticosteroid therapy could terminate the pathway of active fibrosis, thereby inhibiting progression to renal dysfunction.
  • Junnichi Ishii, Hiroshi Takahashi, Fumihiko Kitagawa, Atsuhiro Kuno, Ryuunosuke Okuyama, Hideki Kawai, Takashi Muramatsu, Hiroyuki Naruse, Sadako Motoyama, Shigeru Matsui, Midori Hasegawa, Toru Aoyama, Daisuke Kamoi, Hirotake Kasuga, Hideo Izawa, Yukio Ozaki, Yukio Yuzawa
    CIRCULATION JOURNAL 79(3) 656-663 2015年3月  査読有り
    Background: We prospectively investigated the prognostic value of the combined use of cardiac troponin T (TnT), B-type natriuretic peptide (BNP), and high-sensitivity C-reactive protein (CRP) for long-term mortality in hemodialysis (HD) patients. Methods and Results: Baseline measurements of TnT, BNP, and CRP were performed in 516 patients on chronic HD. Patients were followed up for 10 years. Using the Cox multivariate model with these 3 biomarkers as variables categorized into tertiles for mortality, a simplified score was obtained by underscoring individual biomarkers based on the adjusted hazard ratio (HR). The multimarker score was defined as the sum of these points. TnT, BNP, and CRP levels were individually independent predictors for mortality (P<0.05). Among low-risk (multimarker score <4), intermediate-risk (multimarker score 4-7), and high-risk (multimarker score >= 7) groups, 10-year survival rates were 83.3%, 54.3%, and 27.2% (P<0.0001), respectively. After adjusting for other confounders, the multimarker score had strong predictive power for mortality (HR: 4.26; P<0.0001 for high-risk vs. low-risk group). Furthermore, adding the multimarker score to a baseline model with established risk factors improved the C-index (P<0.01), net reclassification improvement (P<0.0001), and integrated discrimination improvement (P<0.0001) greater than that of any single biomarker or baseline model alone. Conclusions: The multimarker approach (ie, simultaneous assessment of TnT, BNP, and CRP, which individually independently predict prognosis) may improve the prediction of long-term mortality in HD patients.
  • Yatsuka Hibi, Nobuki Hayakawa, Midori Hasegawa, Kimio Ogawa, Yoshimi Shimizu, Masahiro Shibata, Chikara Kagawa, Yutaka Mizuno, Yukio Yuzawa, Mitsuyasu Itoh, Katsumi Iwase
    SURGERY TODAY 45(2) 241-246 2015年2月  査読有り
    We herein report the case of a patient with critical hyperkalemia after unilateral adrenalectomy (ADX) for aldosterone-producing adenomas, which were coexisting with primary hyperparathyroidism. A right adrenal tumor oversecreting mineral corticoid was identified in a 62-year-old female whose kidney function had been impaired due to primary hyperaldosteronism and hyperparathyroidism. The ADX improved her hypertension with normalization of the plasma aldosterone concentration, but without adequately increasing her plasma renin activity. Her eGFR further decreased postoperatively, hyperkalemia appeared and the serum potassium level rose to 6.3 mEq/L at 3 months after ADX. Then, treatment with calcium polystyrene sulfonate jelly was started. Eight months after ADX, a left lower parathyroidectomy was performed, and the serum calcium and intact parathyroid hormone levels decreased to the normal range. The hyperkalemia was difficult to control within 20 months postoperatively without treatment with calcium polystyrene sulfonate jelly or hydrocortisone. This suggests that unmasking the renal impairment and relative hypoaldosteronism after ADX might induce critical hyperkalemia.
  • Midori Hasegawa, Junichi Ishii, Fumihiko Kitagawa, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Makoto Tomita, Hiroshi Takahashi, Yukio Ozaki, Yukio Yuzawa
    HEART AND VESSELS 30(1) 81-88 2015年1月  査読有り
    Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular (CV) events. Recently, elevated neutrophil gelatinase-associated lipocalin (NGAL) levels have been reported in patients with heart failure, coronary heart disease, or stroke. Our aim was to assess urinary NGAL as a predictor of CV events in patients with CKD. This was a prospective observational cohort study of 404 patients with predialysis CKD. CV events were defined as CV death, acute coronary syndrome, hospitalization for worsening heart failure, stroke and dissection of aorta. During a mean follow-up period of 33 months, 77 CV events (19.1 %) occurred. After adjustment for gender, age, diabetes, previous cardiovascular disease, urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate, hemoglobin, and high-sensitivity C-reactive protein, patients with the other quartiles of urinary NGAL had significantly higher risk of CV events compared with patients with the lowest quartile (hazard ratio (HR) 2.81, 95 % confidence interval (CI) 1.01-7.81, P = 0.047 for Q2, HR 3.31, 95 % CI 1.22-9.00, P = 0.019 for Q3, and HR 3.27, 95 % CI 1.15-9.29, P = 0.026 for Q4). Regarding the combination of urinary NGAL with UACR, we also stratified patients into four groups according to whether the level of each marker was above or below the median (61.8 mu g per gram creatinine (gCr) for NGAL and 351.1 mg/gCr for UACR). Four-year CV event-free survival rates were 89.2, 79.6, 71.8, and 51.5 % in order for the four respective groups (P < 0.0001). Elevated urinary NGAL was able to predict future CV events in CKD patients, and had incremental predictive value with elevated UACR.
  • Junnichi Ishii, Hiroshi Takahashi, Midori Hasegawa, Ryuunosuke Okuyama, Hideki Kawai, Takashi Muramatsu, Hiroyuki Naruse, Sadako Motoyama, Shigeru Matsui, Hideo Izawa, Yukio Yuzawa, Yukio Ozaki
    CIRCULATION 130 2014年11月  査読有り
  • Midori Hasegawa, Hitomi Sasaki, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Makoto Tomita, Asami Takeda, Kiyotaka Hoshinaga, Yukio Yuzawa
    CEN case reports 3(2) 167-171 2014年11月  査読有り
    A 27-year-old man was diagnosed with IgA nephropathy and Crohn's disease. He had been diagnosed with proteinuria and hematuria since he was 20 years old. Diarrhea had been a continuing problem during the past 5 months. Neither corticosteroid therapy nor tonsillectomy was performed. Hemodialysis was required at age of 30, while the symptoms of Crohn's disease were ameliorated by an elemental diet. He received a renal transplant from his mother 4 months after starting dialysis therapy. The initial immunosuppression therapy consisted of methylprednisolone, mycofenolate mofetil, cyclosporine, and basiliximab. Eight months after transplantation, proteinuria and hematuria appeared and serum creatinine was 1.4 mg/dL. Relapse of IgA nephropathy was confirmed by the one-year protocol biopsy. He had suffered from tonsillitis at 32 months after the transplantation. Urinary protein increased to 3 g/day and serum creatinine was elevated to 2.04 mg/dL. Renal biopsy was performed 2 weeks after the urinary findings were aggravated. The cellular crescents constituted 36 % of the glomeruli. The findings of rejection were not confirmed in both biopsies. Tonsillectomy was performed thereafter. No additional immunosuppressive therapy was added. Proteinuria and hematuria disappeared at 4 and 20 months, respectively, after tonsillectomy, even when the symptoms of Crohn's disease worsened 69 months and 89 months after transplantation. A renal biopsy was performed 101 months after transplantation. Although IgA in the mesangium area was confirmed by immunohistochemical staining, no active lesion was seen. Tonsillectomy along with immunosuppressants for the graft might be an effective treatment for some patients with active recurrent IgA nephropathy.
  • 秋山 玲奈, 清水 弘太, 北川 香織, 齋藤 優太, 竹内 陵, 木下 由華, 鈴木 むつみ, 橋詰 英明, 〆田 実, 杉森 美幸, 山田 幸恵, 石川 正敏, 三澤 健治, 宮本 晃子, 新 典雄, 加藤 政雄, 堀 秀生, 長谷川 みどり, 湯澤 由紀夫
    日本アフェレシス学会雑誌 33(Suppl.) 202-202 2014年9月  
  • 伊藤 辰将, 高橋 和男, 金山 恭子, 林 宏樹, 小出 滋久, 富田 亮, 長谷川 みどり, 湯澤 由紀夫
    日本腎臓学会誌 55(6) 1186-1186 2013年8月  
  • Hasegawa M, Ishii J, Kitagawa F, Kanayama K, Takahashi H, Ozaki Y, Yuzawa Y
    Heart Vessels. 28(4) 473-479 2013年6月  査読有り
  • 大橋 篤, 堀 秀生, 川口 和紀, 中井 滋, 北口 暢哉, 比企 能之, 富田 亮, 長谷川 みどり, 湯澤 由紀夫
    日本透析医学会雑誌 46(Suppl.1) 495-495 2013年5月  
  • 近藤 亜矢子, 高橋 和男, 秋山 真一, 林 宏樹, 小出 滋久, 富田 亮, 長谷川 みどり, 比企 能之, 三浦 惠二, 湯澤 由紀夫
    日本腎臓学会誌 55(3) 332-332 2013年4月  査読有り
  • 林 宏樹, 金山 恭子, 伊藤 和則, 杉山 和寛, 多田 将士, 高橋 和男, 小出 滋久, 富田 亮, 長谷川 みどり, 湯澤 由紀夫
    日本腎臓学会誌 55(3) 426-426 2013年4月  査読有り
  • Yoshihiro Yamamoto, Yoshiyuki Hiki, Shigeru Nakai, Koichiro Yamamoto, Kazuo Takahashi, Shigehisa Koide, Kazutaka Murakami, Makoto Tomita, Midori Hasegawa, Shiro Kawashima, Satoshi Sugiyama, Yukio Yuzawa
    CLINICAL AND EXPERIMENTAL NEPHROLOGY 17(2) 218-224 2013年4月  査読有り
    To clarify the therapeutic impact of tonsillectomy and combined therapies of tonsillectomy plus steroid on the long-term prognosis of immunoglobulin A nephropathy (IgAN). A retrospective study was conducted on 208 patients with IgAN between 1986 and 2009. According to the strategies for treatments, patients were divided into four groups: tonsillectomy and steroid pulse (TSP, n = 47), tonsillectomy and oral steroid (TOS, n = 33), tonsillectomy alone (T, n = 56), and N group (no particular therapy, n = 72). Multivariate analysis based on the Cox's regression model was used to assess the relative risk of reaching the outcome of doubling creatinine based on the influence of baseline prognostic factors. The mean observation periods were 53.8 months in the TSP group, 122.0 months in the TOS group, 102.9 months in the T group, and 84.6 months in the N group. During an observation period, serum creatinine levels doubled as follows: one in the TSP group (2.1 %), two in the TOS group (6.1 %), five in the T group (8.9 %), histological severity, and 22 in the N group (30.6 %). The Cox's regression proportional hazard model showed that gender, age, histological activity, dialysis induction risk and therapy were associated with doubling creatinine levels. Hazard ratios (95 % CI) and (P value) in T, TOS, and TSP groups versus N were 0.314 (0.11-0.93, P = 0.037), 0.213 (0.04-1.10, P = 0.065), and 0.032 (0.00-0.28, P = 0.002), respectively. A combination therapy of tonsillectomy and steroid pulse had the most significant therapeutic impact compared to other therapies.
  • Naruse Hiroyuki, Ishii Junnichi, Okuyama Ryuunosuke, Hashimoto Tousei, Hattori Kousuke, Okumura Masanori, Matsui Shigeru, Hasegawa Midori, Izawa Hideo, Yuzawa Yukio, Ozaki Yukio
    CIRCULATION 126(21) 2012年11月20日  査読有り
  • 小林 由典, 村上 和隆, 小島 昌泰, 新居 春菜, 荒瀬 友紀子, 金山 恭子, 多田 将士, 山本 義浩, 杉山 和寛, 山本 幸一郎, 高橋 和男, 林 宏樹, 小出 滋久, 富田 亮, 長谷川 みどり, 大橋 篤, 湯澤 由紀夫
    日本透析医学会雑誌 45(Suppl.1) 960-960 2012年5月  
  • 大橋 篤, 堀 秀生, 川口 和紀, 中井 滋, 北口 暢哉, 比企 能之, 深谷 忍, 山下 満, 小川 忠, 村上 和隆, 富田 亮, 長谷川 みどり, 湯澤 由紀夫
    日本透析医学会雑誌 45(Suppl.1) 480-480 2012年5月  
  • 小島 昌泰, 杉山 和寛, 長谷川 みどり, 桐山 諭和, 黒田 誠, 湯澤 由紀夫
    Therapeutic Research 33(8) 1176-1177 2012年  査読有り
  • 長谷川 みどり, 金山 恭子, 大橋 篤, 湯澤 由紀夫
    人工臓器 40(2) S54-S54 2011年10月  
  • Tousei Hashimoto, Junichi Ishii, Masanori Okumura, Hiroyuki Naruse, Yoshihisa Mori, Shigeru Matsui, Midori Hasegawa, Masanori Nomura, Yukio Yuzawa, Yukio Ozaki
    JOURNAL OF CARDIAC FAILURE 17(9) S164-S164 2011年9月  査読有り
  • 近藤 亜矢子, 林 宏樹, 小出 滋久, 村上 和隆, 鍋島 邦浩, 富田 亮, 長谷川 みどり, 石川 清仁, 湯澤 由紀夫
    日本腎臓学会誌 53(6) 795-795 2011年8月  
  • Kyoko Kanayama, Atsushi Ohashi, Midori Hasegawa, Fumiko Kondo, Yoshihiro Yamamoto, Mayu Sasaki, Hiroki Hayashi, Masao Kato, Ryoko Hattori, Hiroshi Yamashita, Jiro Arai, Junichi Ishii, Nobuhiko Emi, Yukio Yuzawa
    THERAPEUTIC APHERESIS AND DIALYSIS 15(4) 394-399 2011年8月  査読有り
    Renal failure is a frequent complication in patients with multiple myeloma. Immunoglobulin free light chains (FLCs) form casts in the distal tubules, resulting in renal obstruction, and are also directly toxic to proximal renal tubules. Removal of FLCs contributes to renal recovery. High cut-off (HCO) membrane Theralite2100, protein leaking dialyzer PES210D alpha, plasma separator Evacure1A20 and beta(2) microglobulin adsorption column LixelleS-35 were compared in their FLC removal rate. Dialysis using Theralite2100 or Evacure1A20, diafiltration using PES210D alpha and adsorption using LixelleS-35 were performed in an in vitro circuit. The highest removal rate was obtained by Theralite2100 dialysis among the four blood purification methods. Albumin loss was also the greatest in Theralite2100 dialysis. The removal content of FLCs per 1 g albumin loss was better in PES210D alpha diafiltration. The removal rate of FLCs by Evacure EC1A-20 dialysis was the third highest. Adsorption of FLCs by the beta(2) microglobulin adsorption column Lixelle S-35 was confirmed. In conclusion, Theralite2100 dialysis was the best in removal of FLCs. PES210D alpha diafiltration can remove FLCs with smaller loss of albumin.
  • Midori Hasegawa, Fumiko Kondo, Koichiro Yamamoto, Kazutaka Murakami, Makoto Tomita, Kunihiro Nabeshima, Shigeru Nakai, Masao Kato, Atsushi Ohashi, Jiro Arai, Yoshiyuki Hiki, Junichi Ishii, Nobuhiko Emi, Satoshi Sugiyama, Yukio Yuzawa
    THERAPEUTIC APHERESIS AND DIALYSIS 14(5) 451-456 2010年10月  査読有り
    Aggressive removal of circulating free light chains (FLC) by blood purification accompanied by chemotherapy is a promising approach for the treatment of acute renal failure due to myeloma cast nephropathy. Plasma exchange has been performed to remove serum FLC; in order to examine an alternative strategy we performed hemodiafiltration using protein-leaking dialyzers for the treatment of dialysis-dependent acute renal failure due to myeloma cast nephropathy. In the first case with kappa-light chain cast nephropathy, the pre-treatment serum creatinine was 9.65 mg/dL, and the serum kappa-FLC was 27 100 mg/L. Plasma exchange or hemodiafiltration was performed from Monday to Friday during the first several weeks. Chemotherapy was started with high-dose dexamethasone and then switched to bortezomib plus dexamethasone. The mean removal rates of kappa-FLC were 45.8% (one plasma volume) and 66.9% (one-and-a-half plasma volumes) by plasma exchange. The removal rates of kappa-FLC by hemodiafiltration (66.9%, FB210UH beta; 71.6%, PES210D alpha; 75.2%, FXS220) were comparable to those by plasma exchange. In the second case with lambda-light chain cast nephropathy, the pre-treatment serum creatinine was 4.14 mg/dL, and the serum lambda-FLC was 4140 mg/L. The mean removal rates of lambda-FLC were 60.2% (FXS140) and 64.2% (FB210UH beta) by hemodiafiltration. Both cases became dialysis-independent. The combination of an intense blood purification regimen and bortezomib plus dexamethasone therapy appears to be an efficient approach to renal recovery. Hemodiafiltration using protein-leaking dialyzers could become an alternative to plasma exchange as a method of removing FLC.
  • 大橋 篤, 堀 秀生, 川口 和紀, 中井 滋, 北口 暢哉, 比企 能之, 村上 和隆, 鍋島 邦浩, 富田 亮, 長谷川 みどり, 杉山 敏
    日本透析医学会雑誌 43(Suppl.1) 362-362 2010年5月  
  • Yoshiro Fujita, Midori Hasegawa, Kuihiro Nabeshima, Makoto Tomita, Kazutaka Murakami, Shigeru Nakai, Takashi Yamakita, Kayoko Matsunaga
    INTERNAL MEDICINE 49(5) 409-413 2010年  査読有り
    Drug rash with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome (DIHS), is a severe adverse drug reaction affecting multiple organs caused by drug treatment. The current report describes a man who was prescribed zonisamide for epilepsy and subsequently developed widespread skin rash, acute kidney injury, high-grade fever, eosinophilia, liver dysfunction, lymphadenopathy and an increase in antihuman herpesvirus-6 immunoglobulin G titer. Hypersensitivity to zonisamide was confirmed by the skin patch test. Based on these findings, the patient was diagnosed with DRESS/DIHS caused by zonisamide. This is the first report of acute kidney injury due to zonisamide-induced DRESS/DIHS.
  • Yuzawa Y, Hasegawa M, Nabeshima K
    Nihon Jinzo Gakkai shi 52(7) 894-898 2010年  査読有り
  • Kazutaka Murakami, Yukiko Nakanishi, Kazumasa Wakamatsu, Koichiro Yamamoto, Nahoko Kohriyama, Midori Hasegawa, Makoto Tomita, Kunihiro Nabeshima, Yoshiyuki Hiki, Shinsuke Asano, Shiro Kawashima, Yasuhiro Ito, Yoshiro Fujita, Hiroaki Asada, Shigeru Nakai, Satoshi Sugiyama, Shosuke Ito
    BLOOD PURIFICATION 28(3) 209-215 2009年  査読有り
    Background: Diffuse hyperpigmentation is common in patients with chronic renal failure undergoing hemodialysis (HD) or peritoneal dialysis (PD). We previously reported that serum levels of 5-S-cysteinyldopa (5SCD, a pheomelanin precursor) and pheomelanin were significantly elevated in HD patients. Methods: Skin color was assessed using a Mexameter that measures the melanin index (MI) and the erythema index (EI). The upper inner arms (non-sun-exposed site) and the foreheads (sun-exposed site) of HD and PD patients and control subjects were analyzed. Results: MI values on the upper inner arms and on the foreheads of HD and PD patients were significantly higher than in controls. In HD patients, significant correlations were found for serum 5SCD levels with MI and EI on the upper inner arm, and for EI on the forehead. In PD patients, no such correlations were found. Conclusions: Hyperpigmentation in HD patients results partly from accumulation of pheomelanin in the skin. Copyright (C) 2009 S. Karger AG, Basel
  • Midori Hasegawa, Chikako Nishii, Atsushi Ohashi, Makoto Tomita, Shigeru Nakai, Kazutaka Murakami, Kunihiro Nabeshima, Yoshirou Fujita, Junichi Ishii, Yoshiyuki Hiki, Satoshi Sugiyama
    NEPHRON CLINICAL PRACTICE 113(3) C222-C233 2009年  査読有り
    Background/Aims: To clarify the clinical significance of tumor necrosis factor (TNF) receptors in patients with myeloperoxidase (MPO)-anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, we evaluated the cell surface expression of TNF receptor 1 (TNFR1) and TNF receptor 2 (TNFR2). Patients and Methods: 43 patients with MPO-ANCA-associated vasculitis, 16 patients with chronic renal failure, 10 patients with sepsis, 15 patients with systemic lupus erythematosus, and 18 healthy controls were enrolled in this study, and the surface expression levels of TNFR1, TNFR2, CD63, and CD64 on granulocytes were assessed. In 21 patients with MPO-ANCA-associated vasculitis, soluble TNFR1 (sTNFR1), soluble TNFR2 (sTNFR2), and TNF-alpha in the serum were also measured. Results: The surface expression levels of TNFR1 and TNFR2 on granulocytes were significantly higher in patients with MPO-ANCA-associated vasculitis than in the healthy controls, and positively correlated with the Birmingham Vasculitis Activity Score (BVAS). The levels of sTNFR1, sTNFR2, and TNF-alpha in the serum were also significantly higher in patients with MPO-ANCA-associated vasculitis than in the healthy controls. Serum levels of sTNFR1 and sTNFR2 correlated with serum creatinine, while the surface expression of TNFR1 and TNFR2 on the granulocytes did not. There was no significant correlation between the BVAS and CD63 or BVAS and CD64. Conclusion: The surface expression levels of TNFR1 and TNFR2 on granulocytes were upregulated in patients with MPO-ANCA-associated vasculitis and reflected disease activity. Copyright (C) 2009 S. Karger AG, Basel
  • Atsushi Ohashi, Shigeru Nakai, Kazutaka Murakami, Makoto Tomita, Kunihiro Nabeshima, Midori Hasegawa, Yoshinobu Hiki, Satoshi Sugiyama
    Journal of Analytical Bio-Science 31(3) 221-224 2008年6月  査読有り
  • Yoshiyuki Hiki, Kazuo Takahashi, Sachiko Shimozato, Hiroko Odani, Kouichirou Yamamoto, Makoto Tomita, Midori Hasegawa, Kazutaka Murakami, Kunihiro Nabeshima, Shigeru Nakai, Yoshiroh Fujita, Isao Ishida, Hitoo Iwase, Satoshi Sugiyama
    CLINICAL AND EXPERIMENTAL NEPHROLOGY 12(1) 20-27 2008年2月  査読有り
    Background The KM mouse lacks endogenous genes for immunoglobulins and carries the entire human IgH locus and the IgLk transgene. Therefore, human IgA1 does not provoke a hetero-immune response. We had observed mesangial IgA deposits in KM mice given desialo-degalacto (DeS/DeGal) IgA1. Methods In this study, the mice were immunized with synthetic IgA1 hinge (glyco-)peptide before administration of DeS/DeGal IgA1, and the effects of the pre-immunization were evaluated. Mice were divided into sHP, 5GalNAc-sHP and non-immunization groups. In two pre-immunization groups, KLH-conjugated sHP or KLH-5GalNAc- sHP, which has five GalNAc residues, was subcutaneously given three times every 2 weeks. Two weeks after the final pre-immunization, DeS/DeGal IgA1 was administered daily for 5 weeks. Serial serum levels of anti-sHP and anti-IgA1 antibodies were evaluated by ELISA. On the day of the last administration of IgA1, renal biopsy was performed. Results Mesangial IgA deposits were observed in all non-immunized mice. In pre-immunized mice, IgA deposition was not detected in 6 of 13 sHP mice and 1 of 4 5GalNAc-sHP mice. The intensities of IgA deposits were significantly different between sHP groups and non-immunized (P = 0.003) groups. There was a significant inverse correlation between the intensities of IgA deposits and the anti-sHP antibody titers (P = 0.016). Conclusions These results suggest that the anti-IgA1 hinge peptide antibody plays a role in the inhibition of glomerular IgA deposition.
  • Midori Hasegawa, Chikako Nishii, Nao Kabutan, Masao Kato, Atsushi Ohashi, Shigeru Nakai, Kazutaka Murakami, Makoto Tomita, Kunihiro Nabeshima, Yoshiyuki Hiki, Hisaji Oshima, Satoshi Sugiyama
    THERAPEUTIC APHERESIS AND DIALYSIS 11(5) 337-340 2007年10月  査読有り
    To evaluate the therapeutic potential of cytapheresis in myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA)-associated vasculitis, plasma levels of soluble tumor necrosis factor receptors (sTNFR1, sTNFR2) and the expression of TNFR1, TNFR2, and CD63 on granulocytes were measured. The levels of sTNFR1 and sTNFR2, and the expression of TNFR1 and TNFR2 were significantly higher in MPO-ANCA-associated vasculitis patients than in normal controls. The levels of sTNFR1 and sTNFR2 increased significantly after cytapheresis (P < 0.001). The expression of TNFR1 showed a tendency to decrease after cytapheresis (P = 0.0535). The expression of CD63 decreased significantly after cytapheresis (P < 0.05). Because sTNFR1 and sTNFR2 act as TNF-antagonists, the increases of sTNFR1 and sTNFR2 after cytapheresis might contribute to inhibit the action of TNF-alpha. The decreased expression of TNFR1, which mediates the signal for polymorphonuclear cell respiratory burst, might also contribute to the reduction of inflammation. From these results, the inhibition of TNF action and removal of degranulated granulocytes appear to be related to the mechanism whereby cytapheresis can exert a beneficial and therapeutic function in the treatment of MPO-ANCA-associated vasculitis.
  • Kazutaka Murakami, Makoto Tomita, Nahoko Kawamura, Midori Hasegawa, Kunihiro Nabeshima, Yoshiyuki Hiki, Satoshi Sugiyama
    Clinical and Experimental Nephrology 11(3) 225-229 2007年9月  査読有り
    We report a case of a 59-year-old woman who had severe metabolic acidosis and hypokalemia due to an enterovesical fistula. The patient came to our hospital complaining of systemic weakness and numbness of the fingers. She was found to have hyperchloremic metabolic acidosis (arterial bicarbonate, 2.8mEq/l) and hypokalemia (serum potassium, 1.9mEq/l) and was admitted for treatment. Following the correction of metabolic acidosis and hypokalemia, the patient was examined for the underlying cause of these electrolyte and acid-base disorders. She had a history of total hysterectomy followed by radiotherapy due to uterine cancer 30 years previously. After the surgery, she had suffered postoperative neurogenic bladder dysfunction, necessitating intermittent self-catheterization. Two years before admission, she had begun to experience watery diarrhea. A radiographic study after recovery from the acid-base and electrolyte disorders revealed the presence of an enterovesical fistula. The fistula was surgically resected and the metabolic acidosis completely cleared. Unexplained hyperchloremic metabolic acidosis with hypokalemia may suggest the presence of an enterovesical fistula in patients with a surgical history of malignant pelvic tumor and neurogenic bladder dysfunction. © 2007 Japanese Society of Nephrology.
  • Kazutaka Murakami, Atsushi Ohashi, Hideo Hori, Makoto Hibiya, Yumiko Shoji, Miyuki Kunisaki, Miho Akita, Akira Yagi, Kazuhiro Sugiyama, Sachiko Shimozato, Kazuhiro Ito, Hiroki Takahashi, Kazuo Takahashi, Kouichirou Yamamoto, Masami Kasugai, Nahoko Kawamura, Shigeru Nakai, Midori Hasegawa, Makoto Tomita, Kunihiro Nabeshima, Yoshiyuki Hiki, Satoshi Sugiyama
    BLOOD PURIFICATION 25(3) 290-294 2007年  査読有り
    Bisphenol A [BPA, 2,2-bis(4-hydoxyphenyl)propane], an industrial chemical used in the production of polycarbonate, epoxide resin, and polyarylate, is considered to be an endocrine-disrupting chemical. BPA may be present in some hollow-fiber dialyzers used in hemodialysis. In this study, we tested the amounts of BPA eluted from various hollow fibers. Furthermore, we measured the BPA concentration in the sera of 22 renal disease predialysis patients, as well as 15 patients who were receiving hemodialysis, to see if there is BPA accumulation in these patients. The elution test of BPA showed that a much larger amount of BPA was eluted from polysulfone (PS), and polyester-polymeralloy hollow fibers. Among renal disease patients who had not undergone hemodialysis, the serum BPA concentration increased as the renal function deteriorated, showing a significant negative association. In a crossover test between PS and cellulose (Ce) dialyzers, the predialysis serum BPA concentration of PS dialyzer users decreased after changing to a Ce dialyzer, and the serum BPA increased again after switching back to PS dialyzers. In patients who were using PS dialyzers, the BPA level significantly increased after a dialysis session. However, in the Ce dialyzer users, the BPA level decreased. Since accumulation of BPA could affect the endocrine or metabolic system of the human body, it is important to perform further investigations on dialysis patients. Copyright (c) 2007 S. Karger AG, Basel.
  • Midori Hasegawa, Atsushi Ohashi, Nao Kabutan, Saori Hiramatsu, Masao Kato, Kazutaka Murakami, Makoto Tomita, Kunihiro Nabeshima, Yoshiyuki Hiki, Satoshi Sugiyama
    THERAPEUTIC APHERESIS AND DIALYSIS 10(5) 412-418 2006年10月  査読有り
    Twenty-one patients with myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA)-associated vasculitis were treated using cytapheresis. Of these, 17 were treated for glomerulonephritis and four were treated for pulmonary hemorrhage. The overall survival rate was 85.7% with a follow-up duration of 24.0 +/- 13.8 months. In the 17 patients with MPO-ANCA-associated glomerulonephritis, pretreatment creatinine was 3.2 +/- 1.6 mg/dL, and renal function recovered in 76.5%. Pulmonary hemorrhage was ameliorated in all four patients. Abdominal pain occurred in three of the 21 patients but symptoms resolved soon after the cytapheresis procedure was completed. No other adverse effects occurred during cytapheresis. From these results, cytapheresis can be considered a safe and effective treatment for MPO-ANCA-associated vasculitis. As for the mechanism of its action, soluble tumor necrosis factor receptor 1 (sTNFR), sTNFR2 and interleukin 1 receptor antagonist were elevated soon after cytapheresis and those levels 2 h after the cytapheresis procedure were higher than before the procedure in some cases. These elevations might be related to the efficacy of cytapheresis.
  • 比企 能之, 高橋 和男, 伊藤 美由紀, 井上 和子, 村上 和隆, 鍋島 邦浩, 長谷川 みどり, 富田 亮, 岩瀬 仁勇, 杉山 敏
    日本腎臓学会誌 48(3) 201-201 2006年4月  査読有り
  • Atsushi Ohashi, Hirohisa Kotera, Hideo Hori, Makoto Hibiya, Koji Watanabe, Kazutaka Murakami, Midori Hasegawa, Makoto Tomita, Yoshinobu Hiki, Satoshi Sugiyama
    Journal of Artificial Organs 8(4) 252-256 2005年12月  査読有り
    Polyvinyl chloride (PVC) tubing is an indispensable medical material for extracorporeal circulation therapy. However, di(2-ethylhexyl)phthalate (DEHP), a suspected endocrine disruptor, can be eluted from PVC, suggesting that an alternative material that does not contain DEHP is needed for clinical applications. First, we evaluated the endocrine disrupting risks of the plasticizers contained in PVC tubes by investigating their binding affinities for the human estrogen receptor alpha (ERα). Our results revealed that, while DEHP has some binding affinity for ERα, neither epoxidized soybean oil nor tris(2-ethylhexyl)trimellitate (an alternative to DEHP) has any affinity for ERα. Second, we evaluated the endocrine disrupting risks of a tube made of newly developed plasticizer-free (PF) materials. We confirmed the presence of DEHP and detected several unidentified substances in plasma stored within the PVC tube. This plasma's competitive binding affinity for ERα was significantly higher than that of control plasma (P &lt 0.01). In contrast, the profile of plasma stored in the PF tube was similar to that of the control, both in terms of high-performance liquid chromatography chromatograms and competitive binding capacity for ERα, suggesting that the PF tube is biocompatible and is useful for reducing the elution of substances capable of binding to ERα. © The Japanese Society for Artificial Organs 2005.
  • M Hasegawa, A Watanabe, H Takahashi, K Takahashi, M Kasugai, N Kawamura, H Kushimoto, K Murakami, M Tomita, K Nabeshima, A Oohashi, F Kondou, H Ooshima, Y Hiki, S Sugiyama
    THERAPEUTIC APHERESIS AND DIALYSIS 9(4) 297-302 2005年8月  査読有り
    To evaluate the efficacy of cytapheresis for the treatment of rapidly progressive glomerulonephritis (RPGN) caused by myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis, the renal prognosis and the mortality rate at 1 year after treatment were compared between a Cytapheresis Group and a Steroid Pulse Group. The Cytapheresis Group included 10 patients who were treated with cytapheresis and oral corticosteroids. Five had granulocytapheresis with the Adacolumn (Japan Immuno Research Laboratories Co. Ltd, Takasaki, Japan) and the remaining five had leukocytapheresis with the leukocyte removal filter, Cellsorba (Asahi Medical Co. Ltd, Tokyo, Japan). The Steroid Pulse Group was comprised of 12 patients who were treated with methylprednisolone pulse therapy and oral corticosteroids. In the Cytapheresis Group, renal function recovered in 70% of the patients and the mortality rate was 10%. In the Steroid Pulse Group, renal function recovered in 66.7% and the mortality rate was 33.3%, with infection as the cause of death. Total doses of corticosteroids converted to prednisolone dose during a 1 month period, ranged from 280 mg to 1226 mg in the Cytapheresis Group. On the other hand, these dosages ranged from 2375 mg to 8380 mg in the Steroid Pulse Group. These results indicated that the mortality rate by infection could be reduced by adding cytapheresis therapy. Concerning the mechanism of cytapheresis, anti-inflammatory factors such as soluble tumor necrosis factor receptor, and interleukin-10 reduced after cytapheresis. These changes might be responsible for the efficacy of cytapheresis. In conclusion, cytapheresis is thought to be one of the effective treatments for RPGN caused by MPO-ANCA-associated vasculitis, reducing the levels of anti-inflammatory factors.
  • 長谷川 みどり, 佐々木 万祐, 下郷 紗智子, 西 冴子, 高橋 弘樹, 高橋 和男, 春日井 雅美, 渡辺 麻子, 川村 奈穂子, 浅野 慎介, 久志本 浩子, 村上 和隆, 富田 亮, 鍋島 邦浩, 比企 能之, 大橋 篤, 杉山 敏
    日本腎臓学会誌 47(3) 305-305 2005年5月  
  • 高橋 和男, 比企 能之, 富田 亮, 長谷川 みどり, 村上 和隆, 鍋島 邦浩, 久志本 浩子, 石田 功, 岩瀬 仁勇, 杉山 敏
    日本腎臓学会誌 47(3) 265-265 2005年5月  査読有り
  • Nahoko Kawamura, Makoto Tomita, Midori Hasegawa, Kazutaka Murakami, Kunihiro Nabeshima, Hiroko Kushimoto, Masami Kasugai, Kazuo Takahashi, Yoshiyuki Hiki, Tsuneo Kinukawa, Nobumitsu Usuda, Satoshi Sugiyama
    Clinical Transplantation, Supplement 19(14) 27-31 2005年  査読有り
    The effects of antibody-mediated rejection on long-term graft survival have not been fully investigated. The aim of this study is to clarify the influence on long-term survival of deposition of the complement split product C4d in allografts using polyclonal anti-C4d antibody. Inclusion criteria were recipients who underwent graft biopsy during acute deterioration of graft function within the first 2 yr after transplantation. Patients whose graft did not survive more than 1 yr and who received graft from an human leucocyte antigen (HLA)-identical sibling or an ABO-incompatible donor were excluded. Among the 92 recipients investigated, 22 (23.9%) had peritubular capillary C4d deposition, 15 (16.3%) had glomerular capillary C4d deposition and seven (7.6%) had both peritubular and glomerular capillary C4d deposition. Twenty of these 22 patients revealed acute cellular rejection, including borderline changes. There was no significant relationship between pathological severity of acute rejection and presence or absence of peritubular capillary C4d deposition. Graft survival was inferior in patients with peritubular capillary C4d deposition to that in patients without C4d deposition (p = 0.0419). Graft survival in patients with glomerular C4d deposition did not differ from that in patients without C4d deposition. In conclusion, C4d deposition in peritubular capillaries has a substantial impact on long-term graft survival. Copyright © Blackwell Munksgaard 2005.
  • N Kawamura, M Tomita, M Hasegawa, K Murakami, K Nabeshima, H Kushimoto, M Kasugai, K Takahasi, Y Hiki, T Kinukawa, N Usuda, S Sugiyama
    CLINICAL TRANSPLANTATION 19 27-31 2005年  査読有り
    The effects of antibody-mediated rejection on long-term graft survival have not been fully investigated. The aim of this study is to clarify the influence on long-term survival of deposition of the complement split product Cod in allografts using polyclonal anti-Cod antibody. Inclusion criteria were recipients who underwent graft biopsy during acute deterioration of graft function within the first 2 yr after transplantation. Patients whose graft did not survive more than 1 yr and who received graft from an human leucocyte antigen (HLA)-identical sibling or an ABO-incompatible donor were excluded. Among the 92 recipients investigated, 22 (23.9%) had peritubular capillary Cod deposition, 15 (16.3%) had glomerular capillary Cod deposition and seven (7.6%) had both peritubular and glomerular capillary Cod deposition. Twenty of these 22 patients revealed acute cellular rejection, including borderline changes. There was no significant relationship between pathological severity of acute rejection and presence or absence of peritubular capillary Cod deposition. Graft survival was inferior in patients with peritubular capillary Cod deposition to that in patients without Cod deposition (p = 0.0419). Graft survival in patients with glomerular Cod deposition did not differ from that in patients without Cod deposition. In conclusion, Cod deposition in peritubular capillaries has a substantial impact on long-term graft survival.
  • Midori Hasegawa, Nahoko Kawamura, Masamitsu Murase, Shigehisa Koide, Hiroko Kushimoto, Kazutaka Murakami, Makoto Tomita, Yoshiyuki Hiki, Masahiko Shikano, Satoshi Sugiyama
    Therapeutic Apheresis and Dialysis 8(3) 212-216 2004年6月  査読有り
    We evaluated the efficacy of granulocytaperesis and leukocytapheresis for the treatment of rapidly progressive glomerulonephritis (RPGN) and lung hemorrhage caused by microscopic polyangiitis. Three patients with RPGN were treated by granulocytapheresis (GCAP) and five patients with RPGN were treated by leukocytapheresis (LCAP). The prednisolone dose was 0.4 ± 0.2 g/kg/day (mean ± SD range 0.2-0.8 g/kg/day). Pre-treatment serum creatinine was 3.2 ± 1.4 mg/dL (1.4-5.1 mg/dL). The patients were followed for a mean period of 15 ± 6 months (6-23 months). Renal function improved in five of the eight RPGN patients. Three lung hemorrhage episodes in two different patients were treated with GCAP and one lung hemorrhage episode was treated with LCAP combined with various doses of corticosteroids. All four lung hemorrhage episodes were ameliorated. We concluded that combined therapy of GCAP or LCAP and corticosteroids is effective for the treatment of RPGN and lung hemorrhage due to microscopic polyangiitis.

MISC

 165
  • Toshikazu Watanabe, Tomoyuki Minezawa, Midori Hasegawa, Yasuhiro Goto, Takuya Okamura, Yosuke Sakakibara, Yoshikazu Niwa, Atsushi Kato, Masamichi Hayashi, Sumito Isogai, Masashi Kondo, Naoki Yamamoto, Naozumi Hashimoto, Kazuyoshi Imaizumi
    BMC pulmonary medicine 19(1) 194-194 2019年11月1日  
    BACKGROUND: Myeloperoxidase anti-neutrophil cytoplasmic antibody-related nephritis (MPO-ANCA nephritis) is occasionally accompanied by lung abnormalities such as pulmonary fibrosis. However, the clinical features of pulmonary fibrosis in patients with MPO-ANCA nephritis have not been well documented. This study was performed to compare the prognosis of a usual interstitial pneumonia (UIP) pattern of lung fibrosis in patients with MPO-ANCA nephritis with the prognosis of idiopathic pulmonary fibrosis (IPF). METHODS: We retrospectively reviewed the medical records of 126 patients with MPO-ANCA nephritis and identified 31 with a UIP pattern of lung fibrosis on high-resolution or thin-slice computed tomography (CT). We compared the characteristics and prognosis of these patients with those of 32 patients with IPF. In 18 patients from both groups, we assessed and compared the decline in lung volume over time using three-dimensional (3D) CT images reconstructed from thin-section CT data. RESULTS: The numbers of male and female patients were nearly equal among patients with MPO-ANCA nephritis exhibiting a UIP pattern; in contrast, significant male dominancy was observed among patients with IPF (p = 0.0021). Significantly fewer smokers were present among the patients with MPO-ANCA nephritis with a UIP pattern than among those with IPF (p = 0.0062). There was no significant difference in the median survival time between patients with MPO-ANCA nephritis with a UIP pattern (50.8 months) and IPF (55.8 months; p = 0.65). All patients with IPF in this cohort received antifibrotic therapy (pirfenidone or nintedanib). Almost half of the deaths that occurred in patients with MPO-ANCA nephritis with a UIP pattern were caused by non-respiratory-related events, whereas most deaths in patients with IPF were caused by respiratory failure such as acute exacerbation. In the 3D CT lung volume analyses, the rate of decline in lung volume was equivalent in both groups. CONCLUSIONS: MPO-ANCA nephritis with a UIP pattern on CT may have an unfavorable prognosis equivalent to that of IPF with a UIP pattern treated with antifibrotic agents.
  • 大山友香子, 高橋和男, 山口央輝, 松下祥子, 伊藤辰将, 中嶋和紀, 林宏樹, 小出滋久, 坪井直毅, 稲熊大城, 長谷川みどり, 湯澤由紀夫
    日本腎臓学会誌 61(3) 287 2019年5月15日  
  • 大山友香子, 高橋和男, 山口央輝, 松下祥子, 伊藤辰将, 中嶋和紀, 林宏樹, 小出滋久, 坪井直毅, 稲熊大城, 長谷川みどり, 湯澤由紀夫
    日本腎臓学会誌 61(3) 340 2019年5月15日  
  • 佐々木ひと美, 倉橋浩樹, 長谷川みどり, 剣持敬, 日下守, 市野学, 住友誠, 白木良一
    日本移植学会総会プログラム抄録集 55th 2019年  
  • 佐々木ひと美, 長谷川みどり, 鈴木敦詞, 深見直彦, 市野学, 日下守, 剣持敬, 白木良一
    日本臨床腎移植学会プログラム・抄録集 52nd 2019年  
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