研究者業績

湯澤 由紀夫

Yukio Yuzawa

基本情報

所属
藤田医科大学 医学部 腎臓内科学
学位
医学博士(1987年6月 名古屋大学)

J-GLOBAL ID
200901012024251132
researchmap会員ID
1000320905

1981(S56)年4月 名古屋第一赤十字病院卒後臨床研修、修了後 同病院内科勤務

1986(S61)年2月 名古屋大学医学部第三内科 助手

1987(S62)年7月 米国ニューヨーク州立大学バッファロー校 病理学教室 Visiting Associate Professor

1990(H2)年5月 名古屋大学医学部附属病院 第三内科勤務

2002(H14)年4月 名古屋大学大学院医学研究科病態内科学講座免疫応答内科学講師

2009(H21)年7月 名古屋大学大学院病態内科学講座腎臓内科学准教授

2010(H22)年4月 藤田保健衛生大学医学部腎内科学(現・藤田医科大学医学部腎臓内科学)主任教授

2011(H23)年5月 藤田保健衛生大学病院(現・藤田医科大学病院)副院長

2014(H26)年4月 藤田保健衛生大学病院(現・藤田医科大学病院)病院長

2019(H31)年4月 藤田医科大学 統括副学長

2021(R3)年7月-現在 藤田医科大学 学長

2021(R3)年9月-2022(R4)年8月 藤田医科大学・病院群 統括病院長(兼任)


学歴

 1

論文

 274
  • Daijo Inaguma, Yoshitaka Tatematsu, Naoki Okamoto, Soshiro Ogata, Hideki Kawai, Eiichi Watanabe, Yukio Yuzawa, Midori Hasegawa, Naotake Tsuboi
    BMJ open 14(1) e076962 2024年1月24日  
    INTRODUCTION: Coronary artery and heart valve calcification is a risk factor for cardiovascular death in haemodialysis patients, so calcification prevention should be started as early as possible. Treatment with concomitant calcimimetics and low-dose vitamin D receptor activators (VDRAs) is available, but not enough evidence has been obtained on the efficacy of this regimen, particularly in patients with short dialysis duration. Therefore, this study will evaluate the efficacy and safety of early intervention with upacicalcet, a calcimimetic used to prevent coronary artery calcification in this patient population. METHODS AND ANALYSIS: This multicentre, open-label, randomised, parallel-group controlled study will compare an early intervention group, which received upacicalcet and a low-dose VDRA, with a conventional therapy group, which received a VDRA. The primary endpoint is a change in log coronary artery calcium volume score from baseline to 52 weeks. The main inclusion criteria are as follows: (1) age 18 years or older; (2) dialysis is planned or dialysis duration is less than 60 months; (3) intact parathyroid hormone (PTH) >240 pg/mL or whole PTH level>140 pg/mL; (4) serum-corrected calcium≥8.4 mg/dL and (5) Agatston score >30. The main exclusion criteria are as follows: (1) history of parathyroid intervention or fracture in the past 12 weeks; (2) history of myocardial infarction, stroke or leg amputation in the past 12 weeks; (3) history of coronary angioplasty and (4) heart failure of New York Heart Association class III or worse. ETHICS AND DISSEMINATION: The study will comply with the Declaration of Helsinki and the Japanese Clinical Trials Act. The study protocol has been approved by the Fujita Health University Certified Review Board (file no. CR22-052). Written informed consent will be obtained from all participants. Study results will be presented in academic meetings and peer-reviewed academic journals. TRIAL REGISTRATION NUMBER: jRCTs041220126.
  • Hiroya Menjo, Midori Hasegawa, Hidetsugu Fujigaki, Takuma Ishihara, Shun Minatoguchi, Shigehisa Koide, Hiroki Hayashi, Midori Saito, Kazuo Takahashi, Hiroyasu Ito, Yukio Yuzawa, Kuniaki Saito, Naotake Tsuboi
    Internal medicine (Tokyo, Japan) 2023年9月29日  
    Objective The objective of this study was to estimate the humoral immune response evaluated by immunoglobulin G (IgG) against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (RBD-IgG) following the third mRNA COVID-19 vaccination in patients with kidney disease who received immunosuppressive treatment. Methods The primary outcome was RBD-IgG levels after the third SARS-CoV-2 vaccination. The primary comparison was the RBD-IgG levels between patients with kidney disease who received immunosuppressive treatment (n=124) and those who did not (n=33). Results The RBD-IgG levels were significantly lower in the patients with kidney disease who received immunosuppressive treatment than in those who did not receive immunosuppressive treatment. The RBD-IgG levels were lower in patients treated with glucocorticoid monotherapy than in those who did not receive immunosuppressive treatment. Even in patients who received ≤ 5 mg prednisolone, the RBD-IgG levels were significantly lower. Nine of the 10 patients who received rituximab within one year before the first vaccination did not experience seroconversion after the third vaccination. Meanwhile, all nine patients who received rituximab only after the second vaccination experienced seroconversion, even if B cell recovery was insufficient. Patients treated with mycophenolate mofetil plus glucocorticoid plus belimumab had significantly lower RBD-IgG levels than those treated with mycophenolate mofetil plus glucocorticoid. Conclusions The RBD-IgG levels were lower in patients with kidney disease who received immunosuppressive treatment than in those who did not receive immunosuppressive treatment. Low-dose glucocorticoid monotherapy affected the humoral immune response following the third mRNA COVID-19 vaccination.
  • Miho Shimizu, Kengo Furuichi, Tadashi Toyama, Masayuki Yamanouchi, Junichi Hoshino, Shinji Kitajima, Akinori Hara, Yasunori Iwata, Norihiko Sakai, Yukio Yuzawa, Hiroshi Kitamura, Hiroshi Sato, Yugo Shibagaki, Yoshiki Suzuki, Noriko Uesugi, Yoshihiko Ueda, Kentaro Kohagura, Kenichi Samejima, Kazuhiko Tsuruya, Shinichi Nishi, Tomoya Nishino, Hirofumi Makino, Seiichi Matsuo, Yoshifumi Ubara, Hitoshi Yokoyama, Takashi Wada
    Journal of diabetes investigation 2023年7月22日  
    AIMS/INTRODUCTION: This multicenter cohort study retrospectively assessed the association between polar vasculosis and the progression of diabetic kidney disease (DKD) in type 2 diabetes. MATERIALS AND METHODS: We enrolled 811 patients with type 2 diabetes, biopsy-proven DKD, and proteinuria (≥0.15 g/g creatinine [g/day]). The association between polar vasculosis and other kidney lesions was explored. The outcome was DKD progression defined as a composite of renal replacement therapy initiation or 50% decline in estimated glomerular filtration rate (eGFR) from baseline. RESULTS: Of the 811 cases, 677 (83.5%) had polar vasculosis. In multivariate logistic regression analysis, subendothelial widening of the glomerular basement membrane, glomerulomegaly, glomerular class in the Renal Pathology Society classification ≥IIb, vascular lesions, age, eGFR, and hemoglobin A1c were positively associated with polar vasculosis, whereas interstitial fibrosis and tubular atrophy (IFTA) was negatively associated with polar vasculosis. During a median follow-up of 5.2 years, progression of DKD occurred in 322 of 677 (7.4 events/100 person-years) and 79 of 134 (11.4 events/100 person-years) cases with and without polar vasculosis, respectively. Kaplan-Meier analysis showed that polar vasculosis was associated with lower cumulative incidences of DKD progression. Multivariate Cox regression analyses showed that polar vasculosis was associated with a lower risk of DKD progression, regardless of eGFR or proteinuria subgroups. These associations between polar vasculosis and better kidney outcome were unchanged considering all-cause mortality before DKD progression as a competing event. CONCLUSIONS: This study showed that polar vasculosis of DKD was associated with less advanced IFTA and a better kidney outcome in type 2 diabetes with proteinuria.
  • Shoya Oyama, Hiroshi Takahashi, Hiroki Hayashi, Shigehisa Koide, Shigeru Nakai, Kazuo Takahashi, Daijo Inaguma, Midori Hasegawa, Junichi Ishii, Yukio Yuzawa, Naotake Tsuboi
    Fujita medical journal 9(2) 105-112 2023年5月  
    OBJECTIVES: Cardiovascular and renal diseases are closely related. Brain natriuretic peptide (BNP) and urinary albumin are established predictors for cardiac and renal morbidities, respectively. To date, no reports have investigated the combined predictive value of BNP and urinary albumin for long-term cardiovascular-renal events in patients with chronic kidney disease (CKD). The aim of this study was to investigate this theme. METHODS: Four hundred eighty-three patients with CKD were enrolled into this study and followed-up for 10 years. The endpoint was cardiovascular-renal events. RESULTS: During the median follow-up period of 109 months, 221 patients developed cardiovascular-renal events. Log-transformed BNP and urinary albumin were identified as independent predictors for cardiovascular-renal events, with a hazard ratio of 2.59 (95% confidence interval [CI], 1.81-3.72) and 2.27 (95% CI, 1.82-2.84) for BNP and urinary albumin, respectively. For the combined variables, the group with high BNP and urinary albumin had a markedly higher risk (12.41-times; 95% CI 5.23-29.42) of cardiovascular-renal events compared with that of the group with low BNP and urinary albumin. Adding both variables to a predictive model with basic risk factors improved the C-index (0.767, 0.728 to 0.814, p=0.009), net reclassification improvement (0.497, p<0.0001), and integrated discrimination improvement (0.071, p<0.0001) more than each of them alone. CONCLUSIONS: This is the first report to demonstrate that the combination of BNP and urinary albumin can stratify and improve the predictability of long-term cardiovascular-renal events in CKD patients.
  • Eri Koshi-Ito, Daijo Inaguma, Haruka Ishii, Yukio Yuzawa, Daijiro Kabata, Ayumi Shintani, Masaaki Inaba, Masanori Emoto, Katsuhito Mori, Tomoaki Morioka, Shinya Nakatani, Tetsuo Shoji
    Clinical kidney journal 15(12) 2281-2291 2022年12月  
    BACKGROUND: While the risk of exceeding the standard range of phosphorus levels has been investigated, the impact of the degree of fluctuations has not been investigated. METHODS: Data were derived from the Japan Dialysis Active Vitamin D trial, a 4-year prospective, randomized study involving 976 patients without secondary hyperparathyroidism undergoing hemodialysis in Japan. Laboratory data were collected every 6 months and the primary outcome was the time to the occurrence of cardiovascular events. The effect of time-dependent changes in phosphorus levels was assessed using a time-varying Cox proportional hazards regression model. RESULTS: The median serum phosphorus levels at baseline and at the final observation were 4.70 mg/dl [interquartile range (IQR) 3.90-5.30] and 5.00 mg/dl (IQR 4.20-5.80), respectively. Over each 6-month period, phosphorus changes ranged from -7.1 to +6.7 mg/dl, with a median value of -0.1 to +0.3 mg/dl. During follow-up, composite cardiovascular events occurred in 103 of 964 patients. Although the P-value for the interaction between serum phosphorus level fluctuations and baseline phosphorus levels was insignificant, the following trends were observed. First, patients with relatively high initial phosphorus levels over a 6-month period showed a trend towards a higher hazard, with greater changes in the phosphorus level over the 6-month period. Second, it was suggested that oral vitamin D receptor activators could contribute to the relationship between fluctuating phosphorus levels and cardiovascular events. CONCLUSIONS: Our results suggest the importance of maintaining stable phosphorus levels, not only in the normal range, but also without fluctuations, in the risk of cardiovascular events among patients without secondary hyperparathyroidism undergoing maintenance hemodialysis.

MISC

 485

講演・口頭発表等

 155

所属学協会

 6

共同研究・競争的資金等の研究課題

 47

産業財産権

 2