論文 - 伊藤　裕

Impact of Body Mass Index on Major Complications, Multiple Complications, In-hospital Mortality, and Failure to Rescue After Esophagectomy for Esophageal Cancer: A Nationwide Inpatient Database Study in Japan.

Hirano Y, Kaneko H, Konishi T, Itoh H, Matsuda S, Kawakubo H, Uda K, Matsui H, Fushimi K, Itano O, Yasunaga H, Kitagawa Y

Annals of surgery 277 （ 4 ） e785 - e792 2023年04月

ISSN  0003-4932

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Canagliflozin protects the cardiovascular system through effects on the gut environment in non-diabetic nephrectomized rats

Matsui A., Yoshifuji A., Irie J., Tajima T., Uchiyama K., Itoh T., Wakino S., Itoh H.

Clinical and Experimental Nephrology 27 （ 4 ） 295 - 308 2023年04月

ISSN  13421751

　概要を見る

Background: The gut produces toxins that contribute to the cardiovascular complications of chronic kidney disease. Canagliflozin, a sodium glucose cotransporter (SGLT) 2 inhibitor that is used as an anti-diabetic drug, has a weak inhibitory effect against SGLT1 and may affect the gut glucose concentration and environment. Methods: Here, we determined the effect of canagliflozin on the gut microbiota and the serum gut-derived uremic toxin concentrations in 5/6th nephrectomized (Nx) rats. Results: Canagliflozin increased the colonic glucose concentration and restored the number of Lactobacillus bacteria, which was low in Nx rats. In addition, the expression of tight junction proteins in the ascending colon was low in Nx rats, and this was partially restored by canagliflozin. Furthermore, the serum concentrations of gut-derived uremic toxins were significantly increased by Nx and reduced by canagliflozin. Finally, the wall of the thoracic aorta was thicker and there was more cardiac interstitial fibrosis in Nx rats, and these defects were ameliorated by canagliflozin. Conclusions: The increases in colonic glucose concentration, Lactobacillus numbers and tight junction protein expression, and the decreases in serum uremic toxin concentrations and cardiac interstitial fibrosis may have been caused by the inhibition of SGLT1 by canagliflozin because similar effects were not identified in tofogliflozin-treated rats.

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Diagnosis of monoclonal immunotactoid glomerulopathy with positive λ chain by immunoelectron microscopy

Sugita E., Sonoda H., Ryuzaki M., Hashiguchi A., Tokuyama H., Wakino S., Kanda T., Itoh H.

CEN case reports 12 （ 1 ） 7 - 13 2023年02月

ISSN  2192-4449

　概要を見る

We report the case of a 73-year-old-man who developed immunotactoid glomerulopathy (ITG). ITG is a rare disease characterized by proliferative glomerulonephritis and capillary wall deposits with a 10-60 nm diameter microtubular substructure. In monoclonal ITG, immunofluorescence analysis typically exhibits IgG with light chain restriction. Recent reviews recommend distinguishing monoclonal ITG from polyclonal ITG because monoclonal ITG is associated with a higher incidence of hematological disorders and better responsiveness to clone-directed therapy and renal prognosis. In our case, IgG, IgA, and IgM were negative by routine immunofluorescence; however, immunoelectron microscopy revealed positive λ chain. At 6 months after renal biopsy, the IgG λ chain was detected in the serum and urine, reflecting possible monoclonality. Therefore, it is useful to perform immunoelectron microscopy and follow-up with serum and urine protein electrophoresis and immunofixation to diagnose monoclonal ITG, even when routine immunofluorescence shows negative or nonspecific findings.

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Early postoperative non-steroidal anti-inflammatory drugs and anastomotic leakage after oesophagectomy

Hirano, Y; Konishi, T; Kaneko, H; Itoh, H; Matsuda, S; Kawakubo, H; Uda, K; Matsui, H; Fushimi, K; Daiko, H; Itano, O; Yasunaga, H; Kitagawa, Y

BJS-BRITISH JOURNAL OF SURGERY 110 （ 2 ） 260 - 266 2023年01月

ISSN  0007-1323

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Case report: Importance of early and continuous tocilizumab therapy in nephrotic syndrome associated with idiopathic multicentric Castleman disease: A case series

Kojima D., Yamaguchi S., Hashiguchi A., Hayashi K., Uchiyama K., Yoshimoto N., Adachi K., Nakayama T., Nishioka K., Tajima T., Morimoto K., Yoshino J., Yoshida T., Monkawa T., Kanda T., Itoh H.

Frontiers in Medicine 9   1037032 - 1037032 2023年01月

ISSN  2296-858X

　概要を見る

Idiopathic multicentric Castleman disease (iMCD) is a systemic and polyclonal lymphoproliferative disease involving multiple organs, including the kidneys, due to the overproduction of interleukin-6 (IL-6). Recently, several reports have suggested that excessive IL-6 actions in iMCD could have a causal relationship with the development of diverse histopathological renal manifestations that cause nephrotic syndrome. However, the treatment for such cases remains unclear. We report a series of three cases of nephrotic syndrome due to iMCD that helps to delineate the importance of early and continuous therapy with the anti-interleukin-6 receptor antibody tocilizumab. First, treatment was suspended for infectious control, and the patient presented with nephrotic syndrome due to diffuse mesangial and endocapillary hypercellularity without immune deposits complicating acute kidney injury. Second, iMCD was treated with prednisolone alone. The patient suddenly developed nephrotic syndrome due to immune-complex glomerulonephritis, not otherwise specified, complicated with acute kidney injury. In the third case, nephrotic syndrome secondary to membranous glomerulonephritis was diagnosed, with a skin rash and IgE antibodies to tocilizumab, and was therefore treated with prednisolone alone. In contrast to the first two cases, the third progressed to end-stage renal disease on hemodialysis. Taken together, this series suggests that clinicians should maintain clinical vigilance for iMCD as a possible underlying component of nephrotic syndrome, since iMCD presents with a variety of renal pathologies. Prompt initiation and continuous administration of tocilizumab are likely key determinants of renal outcomes in such cases. In particular, when tocilizumab is suspended due to infection or in the perioperative period, consideration of its expeditious resumption should be made, taking into account both the withdrawal period and systemic conditions.

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MEAN ANNUAL INTRADIALYTIC BLOOD PRESSURE DECLINE AND CARDIOVASCULAR EVENTS IN JAPANESE MAINTENANCE HEMODIALYSIS PATIENTS

Takahashi, R; Uchiyama, K; Washida, N; Shibagaki, K; Yanai, A; Nakayama, T; Morimoto, K; Itoh, HI

JOURNAL OF HYPERTENSION 41   E387 - E387 2023年01月

ISSN  0263-6352

"MINERALOCORTICOID RECEPTOR (MR)ASSOCIATED HYPERTENSION" IN "GREEDY ORGAN HYPOTHESIS"

Itoh, H

JOURNAL OF HYPERTENSION 41   E143 - E143 2023年01月

ISSN  0263-6352

CONTINUOUS NON-MUTAGENIC DNA DAMAGE IN PODOCYTES ACTIVATES PATHOGENIC MEMORY T CELLS THROUGH ALTERED DNA METHYLATION

Nakamichi, R; Hayashi, K; Hishikawa, A; Chikuma, S; Yoshimoto, N; Sugita, E; Yoshida, E; Itoh, H

JOURNAL OF HYPERTENSION 41   E86 - E87 2023年01月

ISSN  0263-6352

CLINICAL AND BIOCHEMICAL OUTCOMES OF PATIENTS WITH ALDOSTERONE-PRODUCING ADENOMA AFTER RADIOFREQUENCY ABLATION THERAPY AT KEIO UNIVERSITY HOSPITAL: 2022 REPORT

Kozuma, T; Kobayashi, S; Nakamura, T; Kinouchi, K; Yokota, K; Miyashita, K; Kurihara, I; Takase, K; Nakatsuka, S; Itoh, H

JOURNAL OF HYPERTENSION 41   E314 - E314 2023年01月

ISSN  0263-6352

CHANGE OF PANCREAS VOLUME AND GLUCOSE METABOLIC INDEX WITH THE INCREASE OF WEIGHTS: ANALYSES OF COMPREHENSIVE HEALTH CHECKUP DATA

Sunouchi, M; Inaishi, J; Shimizu, R; Saisho, Y; Takaishi, H; Itoh, H

JOURNAL OF HYPERTENSION 41   E461 - E461 2023年01月

ISSN  0263-6352

CASE REPORT: A RARE CASE OF ALVEOLAR HEMORRHAGE AFTER COVID-19 VACCINATION IN A PATIENT WITH RENAL-LIMITED ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS

Nishioka, K; Yamaguchi, S; Yasuda, I; Yoshimoto, N; Kojima, D; Kaneko, K; Aso, M; Nagasaka, T; Yoshida, E; Uchiyama, K; Tajima, T; Yoshino, J; Yoshida, T; Kanda, T; Itoh, H

JOURNAL OF HYPERTENSION 41   E443 - E443 2023年01月

ISSN  0263-6352

BODY MASS INDEX TRAJECTORY AND TECHNIQUE FAILURE OR DEATH IN PATIENTS INITIATING PERITONEAL DIALYSIS

Kojima, D; Uchiyama, K; Hama, EY; Nagasaka, T; Kusahana, E; Nakayama, T; Morimoto, K; Kanda, T; Washida, N; Itoh, H

JOURNAL OF HYPERTENSION 41   E385 - E385 2023年01月

ISSN  0263-6352

BILATERAL ADRENAL TUMORS IN A PATIENT WITH PRIMARY ALDOSTERONISM CONCURRENT WITH CUSHING'S SYNDROME: A CASE REPORT.

Otomo, Y; Irie, J; Miyashita, K; Kobayashi, S; Kinouchi, K; Nakamura, T; Kubota, Y; Nishimura, T; Itoh, H

JOURNAL OF HYPERTENSION 41   E510 - E510 2023年01月

ISSN  0263-6352

ASSOCIATION BETWEEN DNA METHYLATION AGE OR DNA DAMAGE IN URINARY SHEDDING CELLS AND EARLY CKD

Hishikawa, A; Hayashi, K; Sugita, E; Yoshimoto, N; Nakamichi, R; Yoshida, E; Shimizu, R; Takaishi, H; Itoh, H

JOURNAL OF HYPERTENSION 41   E85 - E86 2023年01月

ISSN  0263-6352

Antineutrophil cytoplasmic antibody-associated vasculitis predominantly manifesting tubulointerstitial nephritis: A case report

Nishioka K., Yamaguchi S., Hashiguchi A., Yoshimoto N., Tajima T., Yasuda I., Uchiyama K., Kaneko K., Aso M., Yoshino J., Monkawa T., Kanda T., Hayashi K., Itoh H.

SAGE Open Medical Case Reports 11   2050313X231197324 2023年01月

ISSN  2050-313X

　概要を見る

The common histopathology of antineutrophil cytoplasmic antibody-associated vasculitis comprises pauci-immune crescentic glomerulonephritis with concomitant tubulointerstitial nephritis. Tubulointerstitial nephritis in the absence of glomerular involvement in patients with antineutrophil cytoplasmic antibody-associated vasculitis is uncommon. We report a case of antineutrophil cytoplasmic antibody-associated vasculitis-associated acute kidney injury manifesting as tubulointerstitial nephritis without glomerulonephritis. A 75-year-old woman with fever, cough, and myalgia developed kidney dysfunction with inflammatory reactions and tubular-type proteinuria, without glomerular hematuria. A kidney biopsy revealed tubulointerstitial nephritis with arteritis. We ruled out important underlying etiologies of tubulointerstitial nephritis, including infection, drug reactions, and autoimmune diseases. Since chest high-resolution computed tomography demonstrated mild interstitial pneumonia in bilateral lower lung fields, myeloperoxidase antineutrophil cytoplasmic antibody was measured and found to be positive. Therefore, we diagnosed the patient with antineutrophil cytoplasmic antibody-associated vasculitis-associated tubulointerstitial nephritis but not glomerulonephritis, and interstitial pneumonia. The patient’s kidney function and symptoms markedly improved with prednisolone treatment. Clinicians should maintain high-level vigilance for antineutrophil cytoplasmic antibody-associated vasculitis as a possible underlying component of tubulointerstitial nephritis, particularly when kidney function deteriorates with tubulointerstitial injuries without glomerular features.

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ADENINE NEPHROPATHY IS ALLEVIATED BY ANTI-INFLAMMATORY PROPERTY OF SODIUM BENZOATE

Oshima, Y; Wakino, S; Kanda, T; Tajima, T; Itoh, T; Uchiyama, K; Yoshimoto, K; Sasabe, J; Itoh, H

JOURNAL OF HYPERTENSION 41   E367 - E368 2023年01月

ISSN  0263-6352

A CASE OF RESISTANT HYPERTENSION

Nakajima, Y; Irie, J; Nakamura, T; Kawano, Y; Ito, A; Kinouchi, K; Kobayashi, S; Meguro, S; Itoh, H

JOURNAL OF HYPERTENSION 41   E440 - E440 2023年01月

ISSN  0263-6352

A CASE OF PRIMARY ALDOSTERONISM WITH DECLINED GLOMERULAR FILTRATION RATE AFTER ADRENALECTOMY

Kohmoto, H; Kobayashi, S; Miyashita, K; Kinouchi, K; Nakamura, T; Mizutani, Y; Takeda, T; Oya, M; Tamura, M; Nakatsuka, S; Itoh, H

JOURNAL OF HYPERTENSION 41   E511 - E511 2023年01月

ISSN  0263-6352

A CASE OF PATIENT WITH END-STAGE KIDNEY DISEASE INTRODUCED HEMODIALYSIS AFTER CEREBRAL HEMORRHAGE.

Aso, M; Yamaguchi, S; Yasuda, I; Nishioka, K; Kaneko, K; Kanda, T; Itoh, H

JOURNAL OF HYPERTENSION 41   E508 - E508 2023年01月

ISSN  0263-6352

A CASE OF ALDOSTERONE-PRODUCING ADENOMA DIAGNOSED BY ADRENAL ARTERIOGRAPHY AND BRANCH SELECTIVE ADRENAL VENOUS SAMPLING

Nishikawa, M; Kinouchi, K; Kobayashi, S; Miyashita, K; Takeda, T; Tamura, M; Nakatsuka, S; Mizutani, Y; Otomo, Y; Aoyama, K; Yokota, K; Kurihara, I; Itoh, H

JOURNAL OF HYPERTENSION 41   E345 - E346 2023年01月

ISSN  0263-6352