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

  • 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.

  • Effects of renin-angiotensin system inhibitors on the incidence of unplanned dialysis

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

    Hypertension Research (Hypertension Research)  45 ( 6 ) 1018 - 1027 2022.06

    Research paper (scientific journal), Joint Work, Accepted,  ISSN  09169636

     View Summary

    Unplanned dialysis initiation is associated with poor outcomes. It is controversial whether patients with advanced chronic kidney disease (CKD) should receive renin-angiotensin system (RAS) inhibitor therapy. The aim of this study was to evaluate the effect of RAS inhibitor therapy in patients with advanced CKD on the incidence of unplanned dialysis initiation. This single-center, retrospective study included patients who started maintenance dialysis at our hospital between April 2014 and March 2021. Patients who initiated dialysis within 6 months of nephrology referral or after kidney transplant were excluded. Among 334 patients (aged 70.0 [59.0–79.0] years; 28.4% women), 186 (55.7%) and 148 (44.3%) had planned and unplanned dialysis initiation, respectively. Multivariate logistic regression analysis revealed that the use of RAS inhibitors was significantly associated with a lower incidence of unplanned dialysis initiation (odds ratio [OR], 0.36; P < 0.01). Female sex (OR, 0.41; P < 0.05), use of potassium binders (OR, 0.28; P < 0.001), earlier referral to nephrology (OR, 0.39; P < 0.01), and earlier discussion of renal replacement therapy (OR, 0.33; P < 0.001) were also significantly associated with a lower incidence, whereas older age (OR, 1.28; P < 0.05), higher Charlson Comorbidity Index (OR, 1.24; P < 0.05), and faster decline in kidney function (OR, 1.29; P < 0.01) were associated with a higher risk of unplanned dialysis initiation. RAS inhibitor therapy in patients with advanced CKD is associated with a lower risk of unplanned dialysis initiation.

  • Development of Alveolar Hemorrhage After Pfizer-BioNTech COVID-19 mRNA Vaccination in a Patient With Renal-Limited Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis: A Case Report

    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.

    Frontiers in Medicine (Frontiers in Medicine)  9 2022.04

    Research paper (scientific journal), Joint Work, Accepted

     View Summary

    Since the coronavirus disease 2019 (COVID-19) pandemic continues and a new variant of the virus has emerged, the COVID-19 vaccination campaign has progressed. Rare but severe adverse outcomes of COVID-19 vaccination such as anaphylaxis and myocarditis have begun to be noticed. Of note, several cases of new-onset antineutrophil cytoplasmic antibody-associated vasculitis (AAV) after COVID-19 mRNA vaccination have been reported. However, relapse of AAV in remission has not been recognized enough as an adverse outcome of COVID-19 vaccination. We report, to our knowledge, a first case of renal-limited AAV in remission using every 6-month rituximab administration that relapsed with pulmonary hemorrhage, but not glomerulonephritis, following the first dose of the Pfizer-BioNTech COVID-19 vaccine. The patient received the COVID-19 vaccine more than 6 months after the last dose of rituximab according to the recommendations. However, his CD19+ B cell counts were found to be increased after admission, indicating that our case might have been prone to relapse after COVID-19 vaccination. Although our case cannot establish causality between AAV relapse and COVID-19 mRNA vaccination, a high level of clinical vigilance for relapse of AAV especially in patients undergoing rituximab maintenance therapy following COVID-19 vaccination should be maintained. Furthermore, elapsed time between rituximab administration and COVID-19 mRNA vaccination should be carefully adjusted based on AAV disease-activity.

  • Long-term efficacy and safety of iron-based phosphate binders, ferric citrate hydrate and sucroferric oxyhydroxide, in hemodialysis patients

    Yoshida T., Morimoto K., Kaburagi N., Fujino T., Takemitsu T.Y., Yamashita N., Oya M.

    International Urology and Nephrology (International Urology and Nephrology)  54 ( 4 ) 861 - 872 2022.04

    Research paper (scientific journal), Joint Work, Lead author, Corresponding author, Accepted,  ISSN  03011623

     View Summary

    Purpose: Iron-based phosphate binders, including ferric citrate hydrate (FCH) and sucroferric oxyhydroxide (SFOH), have been used for the treatment of hyperphosphatemia in end-stage renal disease patients on dialysis. However, the long-term efficacy and safety of these agents have not yet been clearly elucidated. Methods: Laboratory data of 56 hemodialysis patients who had been prescribed either FCH (n = 33) or SFOH (n = 23) were retrospectively examined. Results: We showed that both FCH and SFOH significantly and consistently decreased serum phosphate concentrations in the patients undergoing maintenance hemodialysis during the 36-month observation period. Serum levels of calcium, intact parathyroid hormone, as well as hemoglobin levels were unaltered. No overshoot of parameters of iron metabolism, such as transferrin saturation and serum ferritin levels, was observed, and serum ferritin level remained under 300 ng/mL in most patients. A trend towards decrease in the doses of erythropoiesis-stimulating agents used and frequency of intravenous iron use was observed in both treatment groups. No severe adverse drug reactions were observed in either the patients receiving FCH or SFOH. Conclusion: The results of the present study suggest that the iron-based phosphate binders, FCH and SFOH, decrease serum phosphate concentrations consistently and are safe to use over the long-term in maintenance hemodialysis patients.

  • Amiodarone-induced multiple organ damage in an Alström syndrome patient with end-stage renal disease and hepatic cirrhosis

    Torimitsu T., Yoshida T., Makiuchi S., Itoh H., Oya M.

    CEN case reports (CEN case reports)  11 ( 1 ) 11 - 16 2022.02

    Research paper (scientific journal), Joint Work, Corresponding author, Accepted

     View Summary

    Alström syndrome (AS) is an extremely rare disease accompanied by blindness, hearing loss, obesity, type 2 diabetes, dilated cardiomyopathy, and progressive hepatic and renal dysfunction. The life span of AS patients rarely exceeds 50 years, and thus there are very few reports describing the implementation of renal replacement therapy for these patients. We here report a case of AS patient who exhibited dilated cardiomyopathy, end-stage renal disease, and hepatic cirrhosis. He underwent hemodialysis therapy more than 3 years. Although he eventually died of amiodarone-induced multiple organ damage in the lungs and liver, the present case suggests that hemodialysis therapy can be a choice of renal replacement therapy for AS patients with end-stage renal disease.

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

Reviews, Commentaries, etc. 【 Display / hide

Presentations 【 Display / hide

  • 鉄含有リン吸着薬の長期内服の影響

    吉田 理, 森本耕吉, 冠城徳子, 武光智子, 山下賀正, 大家基嗣

    第65回日本腎臓学会学術総会 (神戸) , 

    2022.06

    Oral presentation (general)

  • 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)

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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
    -
    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
    -
    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

    2022

  • CLINICAL ENGINEERING AND SAFETY CONTROL IN HEALTH CARE

    2021

  • CLINICAL ENGINEERING AND SAFETY CONTROL IN HEALTH CARE

    2020

  • GENERAL MEDICINE

    2019

  • CLINICAL ENGINEERING AND SAFETY CONTROL IN HEALTH CARE

    2019

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