Yoshida, Tadashi

写真a

Affiliation

School of Medicine, Apheresis and Dialysis Center (Shinanomachi)

Position

Associate Professor

Related Websites

Profile 【 Display / hide

  • 慢性腎臓病の病態解明を慢性炎症の観点から解析を進めている。また、慢性腎臓病における心血管病変について発生機序の解明、新規治療法の開発を目的とした研究を行っている。

Other Affiliation 【 Display / hide

  • School of Medicine, 医学部総合診療教育センター, Associate Professor

Career 【 Display / hide

  • 1998.04
    -
    2001.09

    Keio University, School of Medicine, Internal Medicine, Instructor

  • 2001.09
    -
    2005.06

    University of Virginia, Department of Molecular Physiology and Biological Physics, Postdoctoral Fellow

  • 2005.07
    -
    2005.10

    University of Virginia, Robert M. Berne Cardiovascular Research Center, Instructor of Research

  • 2005.07
    -
    2005.10

    University of Virginia, Department of Molecular Physiology and Biological Physics, Instructor of Research

  • 2005.11
    -
    2008.08

    University of Virginia, The Robert M. Berne Cardiovascular Research Center, Assistant Professor of Research

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Academic Background 【 Display / hide

  • 1988.04
    -
    1994.03

    Keio University, School of Medicine

    University, Graduated

  • 1994.04
    -
    1998.03

    Keio University, School of Medicine, Department of Internal Medicine

    Graduate School, Completed, Doctoral course

Academic Degrees 【 Display / hide

  • 博士(医学), 慶應義塾大学, Coursework, 1998.03

    培養細胞およびヒトにおけるleptin発現分泌に対する各種ホルモンの影響

Licenses and Qualifications 【 Display / hide

  • 医師免許, 1994.05

  • 日本内科学会認定内科医, 1999.09

  • 日本内科学会総合内科専門医, 2011.12

  • 日本腎臓学会腎臓専門医, 2010.04

  • 日本腎臓学会腎臓指導医, 2015.04

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Research Areas 【 Display / hide

  • Life Science / Nephrology

  • Life Science / Molecular biology

Research Keywords 【 Display / hide

  • 慢性腎臓病

  • 血管石灰化

Research Themes 【 Display / hide

  • 慢性腎臓病における心血管病変について発生機序の解明・新規治療法の開発, 

    2010
    -
    Present

  • 血管平滑筋分化におけるエピジェネティック機構, 

    2001
    -
    Present

 

Books 【 Display / hide

  • 腎臓症候群(第3版)

    吉田 理 他, 日本臨牀社, 2022

    Scope: Alström症候群

  • 腎代替療法選択ガイド2020

    吉田 理 他, ライフサイエンス出版, 2020

    Scope: 第2章 血液透析の選択,  Contact page: 17-36 , Accepted

  • 目でみるトレーニング第4集

    吉田 理 岡崎仁昭 他, 医学書院, 2019

    Scope: 内分泌・代謝,  Contact page: 75-100

  • これまでがワカる。これからがカワる。透析療法最前線

    YOSHIDA Tadashi, 東京医学社, 2018

    Scope: 透析患者の糖尿病管理~血糖コントロールの意義と指標~

  • Encyclopedia of Signaling Molecules, 2nd Edition

    YOSHIDA Tadashi, Springer, 2018

    Scope: Krüppel-like factor 4

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Papers 【 Display / hide

  • 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 (Frontiers in Medicine)  9 2023.01

     View Summary

    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.

  • Clinical significance of serum urea-to-creatinine ratio in patients undergoing peritoneal dialysis

    Tonomura S., Uchiyama K., Nakayama T., Mitsuno R., Kojima D., Hama E.Y., Nagasaka T., Nishimura E.S., Kusahana E., Takahashi R., Yoshimoto N., Yamaguchi S., Morimoto K., Yoshida T., Hayashi K., Kanda T., Washida N., Itoh H.

    Therapeutic Apheresis and Dialysis (Therapeutic Apheresis and Dialysis)   2023

    ISSN  17449979

     View Summary

    Introduction: We aimed to determine the correlation between the serum urea-to-creatinine ratio and residual kidney function (RKF) in patients undergoing peritoneal dialysis (PD), as well as its predictive value for PD-related outcomes. Methods: This study included a cross-sectional study to assess the correlation between serum urea-to-creatinine ratio and RKF in 50 patients on PD and a retrospective cohort study to assess the association between serum urea-to-creatinine ratio and PD-related outcomes in 122 patients who initiated PD. Results: Serum urea-to-creatinine ratios had significant positive correlations with renal Kt/V and creatinine clearance values (r = 0.60, p < 0.001 and r = 0.61, p < 0.001, respectively). Additionally, serum urea-to-creatinine ratio was significantly associated with a lower risk of transfer to hemodialysis or PD/hemodialysis hybrid therapy (hazard ratio: 0.84, 95% confidence interval: 0.75–0.95). Conclusion: The serum urea-to-creatinine ratio can be an indicator of RKF and a prognostic factor in patients undergoing PD.

  • Compared effectiveness of sodium zirconium cyclosilicate and calcium polystyrene sulfonate on hyperkalemia in patients with chronic kidney disease

    Nakayama T., Yamaguchi S., Hayashi K., Uchiyama K., Tajima T., Azegami T., Morimoto K., Yoshida T., Yoshino J., Monkawa T., Kanda T., Itoh H.

    Frontiers in Medicine (Frontiers in Medicine)  10 2023

     View Summary

    Hyperkalemia is a well-recognized electrolyte abnormality in patients with chronic kidney disease (CKD). Potassium binders are often used to prevent and treat hyperkalemia. However, few studies have evaluated the difference in serum potassium (K+) level-lowering effect during the post-acute phase between the novel potassium binder, sodium zirconium cyclosilicate (ZSC), and conventional agents. This retrospective study included patients who received potassium binders (either ZSC or calcium polystyrene sulfonate [CPS]) in our hospital between May 2020 and July 2022. The patients were divided into the ZSC and CPS groups. After propensity score matching, we compared changes from baseline to the first follow-up point, at least 4 weeks after initiating potassium binders, in electrolytes including K+ level between the two groups. Of the 132 patients, ZSC and CPS were administered in 48 and 84 patients, respectively. After matching, 38 patients were allocated to each group. The ZSC group showed greater reduction in K+ levels than did the CPS group (P < 0.05). Moreover, a significant increase in serum sodium minus chloride levels, a surrogate marker for metabolic acidosis, was observed in the ZSC group (P < 0.05). Our results demonstrated that ZSC could potentially improve hyperkalemia and metabolic acidosis in patients with CKD.

  • Serum thymus and activation-regulated chemokine level is associated with the severity of chronic kidney disease-associated pruritus in patients undergoing peritoneal dialysis

    Nakayama T., Morimoto K., Uchiyama K., Kusahana E., Washida N., Azegami T., Kanda T., Yoshida T., Itoh H.

    Peritoneal Dialysis International (Peritoneal Dialysis International)  42 ( 4 ) 415 - 424 2022.07

    Research paper (scientific journal), Joint Work, Accepted,  ISSN  08968608

     View Summary

    Background: Thymus and activation-regulated chemokine (TARC), which induces a Th2-dominated inflammation, is a well-known biomarker that reflects the severity of atopic dermatitis. The present study aimed to evaluate TARC as a Th2-associated marker with chronic kidney disease-associated pruritus (CKD-aP) in patients with peritoneal dialysis (PD). Methods: This single-centre cross-sectional study included patients who underwent PD in our hospital between August 2020 and July 2021. The severity and impaired quality of life (QOL) of CKD-aP were assessed using the visual analogue scale (VAS) and Japanese version of the 5-D itch scale (5D-J), respectively. Results: A total of 48 patients with PD were included in the present study. Age and dialysis vintage were (mean ± SD) 64.8 ± 12.0 year and (median (IQR)) 38.5 (11.5–91.5) month, respectively. VAS and 5D-J scores were 3.3 ± 2.0 and 10.5 (9.0–12.0), respectively. Serum TARC level was 481.5 (278.9–603.4) pg/mL (upper limits of normal 450 pg/mL) and significantly correlated with VAS (r = 0.39, p = 0.006) and 5D-J score (r = 0.37, p = 0.009). Multivariate linear analysis revealed that higher serum TARC level was significantly associated with VAS (p < 0.001) and 5D-J score (p < 0.001). Furthermore, the serum brain natriuretic peptide level tended to be associated with VAS (p = 0.060) and 5D-J score (p = 0.029). Conclusion: Serum TARC level is an independent predictor of the severity and impaired QOL of CKD-aP in patients with PD, and TARC might be involved in the pathogenesis of CKD-aP.

  • Late Dialysis Modality Education Could Negatively Predict Peritoneal Dialysis Selection

    Nakayama T., Nishioka K., Uchiyama K., Morimoto K., Kusahana E., Washida N., Yamaguchi S., Azegami T., Yoshida T., Itoh H.

    Journal of Clinical Medicine (Journal of Clinical Medicine)  11 ( 14 )  2022.07

     View Summary

    Patients with end-stage renal disease are less likely to choose peritoneal dialysis (PD) as renal replacement therapy (RRT). The reasons for this biased selection are still poorly understood. In this study, we evaluated the effect of the timing of RRT education on PD selection. This single-center retrospective observational study included patients who initiated maintenance dialysis at our hospital between April 2014 and July 2021. A logistic regression analysis was performed to investigate the association of RRT education timing with PD selection. Among the 355 participants (median age [IQR] 70 (59–79) years; 28.7% female), 53 patients (14.9%) and 302 patients (85.1%) selected PD and hemodialysis, respectively. Multivariate analysis demonstrated that high estimated glomerular filtration (eGFR) at RRT education positively predicted PD selection (p < 0.05), whereas old age (p < 0.01) and high Charlson comorbidity index (p < 0.05) were negative predictors of PD selection. Female sex (p = 0.44), welfare public assistance (p = 0.78), living alone (p = 0.25), high geriatric nutritional risk index (p = 0.10) and high eGFR at first visit to the nephrology department (p = 0.83) were not significantly associated with PD selection. Late RRT education could increase the biased selection of dialysis modality.

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Papers, etc., Registered in KOARA 【 Display / hide

Reviews, Commentaries, etc. 【 Display / hide

Presentations 【 Display / hide

  • 腎限局型のANCA関連血管炎患者がCOVID-19 mRNAワクチン接種後に肺胞出血を発症し、死亡に至った一例

    西岡 謙, 山口慎太郎, 安田 格, 吉本憲史, 児島大輝, 金子賢司, 麻生満広, 長坂朋輝, 吉田英莉子, 内山清貴, 田島敬也, 吉野 純, 吉田 理, 神田武志, 伊藤 裕

    第67回日本透析医学会学術集会・総会 (横浜) , 

    2022.06

    Poster presentation

  • 免疫抑制剤およびLDL吸着療法により血液透析から離脱できたもののネフローゼレベルの尿蛋白が残存した微小変化型ネフローゼ症候群の一例

    金子賢司, 山口慎太郎, 吉本憲史, 安田 格, 内山清貴, 田島敬也, 林香, 吉野 純, 吉田 理, 神田武志, 伊藤 裕

    第67回日本透析医学会学術集会・総会 (横浜) , 

    2022.06

    Poster presentation

  • ネフローゼ症候群を伴うキャッスルマン病で血液透析に至った一例

    児島大輝, 田島敬也, 山口慎太郎, 内山清貴, 長坂朋輝, 吉田英莉子, 林 香, 吉野 純, 吉田 理, 神田武志, 伊藤 裕

    第67回日本透析医学会学術集会・総会 (横浜) , 

    2022.06

    Poster presentation

  • リンパックTA1からキンダリー5号透析液への変更の影響

    茂田 綾, 吉田 理, 佐藤慎吾, 柴野豊彦, 平林則行, 大家基嗣

    第67回日本透析医学会学術集会・総会 (横浜) , 

    2022.06

    Oral presentation (general)

  • 血液透析見合わせを希望した事例を通しアドバンス・ケア・プランニング(ACP)の実践を考える

    山口伸子, 平島麻衣子, 廣川美穂子, 斎藤みわ, 菅原滋和子, 浦沢智佐, 吉田 理

    第67回日本透析医学会学術集会・総会 (横浜) , 

    2022.06

    Oral presentation (general)

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • 抑制的なヒストンメチル化修飾への介入による血管石灰化の制御

    2021.04
    -
    2024.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

  • ヒストンメチル化修飾への介入による血管石灰化抑制

    2021.02
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    2022.08

    日本透析医会, 公募研究助成, Research grant, Principal investigator

  • 移植腎長期生着へ向けた慢性移植腎症非免疫学的メカニズムの解明と予防法の開発

    2019.04
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    2022.03

    文部科学省, 科学研究費補助金 基盤研究 (C), Research grant, Coinvestigator(s)

  • 血管石灰化における平滑筋細胞でのエピジェネティック機構

    2018.04
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    2019.03

    日本透析医会, 公募研究助成, Research grant, Principal investigator

  • 慢性腎臓病における血管内皮の炎症と中膜石灰化の関係

    2017.03
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    2018.03

    日本透析医会, 公募研究助成, Research grant, Principal investigator

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Intellectual Property Rights, etc. 【 Display / hide

  • 25-hydroxyvitamin D3-1a-hydroxylase and DNA encoding the hydroxylase

    Date applied: United States Patent 6274359  2001.08 

    Patent, Joint

Awards 【 Display / hide

  • American Heart Association ATVB Merit Award for Young Investigators

    2007.11, American Heart Association

  • 慶應義塾大学医学部三四会賞

    1999.11, 慶應義塾大学医学部

 

Courses Taught 【 Display / hide

  • CLINICAL ENGINEERING AND SAFETY CONTROL IN HEALTH CARE

    2024

  • CLINICAL ENGINEERING AND SAFETY CONTROL IN HEALTH CARE

    2022

  • CLINICAL ENGINEERING AND SAFETY CONTROL IN HEALTH CARE

    2021

  • CLINICAL ENGINEERING AND SAFETY CONTROL IN HEALTH CARE

    2020

  • GENERAL MEDICINE

    2019

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Courses Previously Taught 【 Display / hide

  • 腎臓内科学

    Keio University

    2018.04
    -
    2019.03

  • 総合診療医学

    Keio University

    2018.04
    -
    2019.03

  • General Medicine

    Keio University

    2015.04
    -
    2016.03

    Full academic year, Lecture

 

Memberships in Academic Societies 【 Display / hide

  • 日本内科学会

     
  • 日本腎臓学会

     
  • 日本内分泌学会

     
  • 日本透析医学会

     
  • 日本高血圧学会

     

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Committee Experiences 【 Display / hide

  • 2016.06
    -
    Present

    評議員, 日本透析医学会

  • 2015.04
    -
    Present

    評議員, 日本内分泌学会

  • 2013.04
    -
    Present

    評議員, 日本腎臓学会