Uchiyama, Kiyotaka

写真a

Affiliation

School of Medicine, Baxter International Endowed Course for Integrated Renal Replacement Therapy & Translational Medicine (Shinanomachi)

Position

Project Assistant Professor (Non-tenured)/Project Research Associate (Non-tenured)/Project Instructor (Non-tenured)

Career 【 Display / hide

  • 2020.04
    -
    2022.03

    Keio University, School of Medicine Department of Internal Medicine (Nephrology, Endocrinology and Metabolism), Assistant Professor

  • 2022.04
    -
    Present

    Keio University, School of Medicine Department of Internal Medicine (Nephrology, Endocrinology and Metabolism), Project Assistant Professor

Academic Background 【 Display / hide

  • 2000.04
    -
    2006.03

    灘中学校・灘高等学校

  • 2006.04
    -
    2012.03

    Keio University, School of Medicine

  • 2016.04
    -
    2020.03

    Keio University, School of Medicine, 医学研究科博士課程(内科専攻)

 

Research Areas 【 Display / hide

  • Life Science / Nephrology

  • Life Science / Rehabilitation science

 

Books 【 Display / hide

  • イラストでわかる腎臓・透析療法・透析患者の体

    花房, 規男, メディカ出版, 2021.12,  Page: 270p

    Scope: 腹膜透析の種類

  • 血液透析診療指針

    岡田, 一義, 井上, 朋子, 島, 久登, 田代, 学(腎臓内科医), 水口, 潤, 東京医学社, 2021.06,  Page: xvii, 364p

    Scope: ビタミン

  • エビデンスに基づく多発性囊胞腎(PKD)診療ガイドライン

    厚生労働科学研究費補助金難治性疾患等政策研究事業(難治性疾患政策研究事業)難治性腎障害に関する調査研究班, 成田, 一衛, 東京医学社, 2020.08,  Page: xi, 92p

    Scope: 1 進行を抑制する治療 1)降圧療法

  • 臨床検査法提要

    奥村, 伸生, 金井, 正光, 戸塚, 実, 本田, 孝行, 矢冨, 裕, 金原出版, 2020.05,  Page: 2012p

    Scope: 腹膜透析

  • 腹膜透析診療指針

    岡田, 一義, 橋本, 寛文, 水口, 潤, 東京医学社, 2019.07,  Page: ix, 165p

    Scope: カテーテルトラブル診療指針

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Papers 【 Display / hide

  • Effect of Tolvaptan in Patients with Chronic Kidney Disease Stage G5, and Impact of Concomitant Use of Thiazide Diuretics: A Retrospective Cohort Study

    Kiyotaka Uchiyama, Daiki Kojima, Eriko Yoshida Hama, Tomoki Nagasaka, Takashin Nakayama, Rina Takahashi, Takaya Tajima, Kohkichi Morimoto, Naoki Washida, Hiroshi Itoh

    Drugs - Real World Outcomes (Springer Science and Business Media LLC)   2022.08

    Lead author, Corresponding author, Accepted,  ISSN  2199-1154

     View Summary

    Background: The diuretic effect of tolvaptan, a vasopressin V2 receptor antagonist, in patients with severe renal dysfunction remains poorly characterized. Thiazide diuretics reduce urinary volume (UV) in patients with nephrogenic diabetes insipidus, which lacks V2 receptor function. Objective: This retrospective study investigated the acute urinary effects of tolvaptan in patients with stage G5 chronic kidney disease and congestive heart failure (CHF), and the impact of thiazide diuretics on the urinary effects of tolvaptan. Methods: UVs 24 h before and after tolvaptan administration and 30-day dialysis initiation rate were compared between patients with and without thiazide diuretic administration. Results: Thiazide diuretics were used in 26 of the 106 recruited patients (age 73.4 ± 13.0 years; estimated glomerular filtration rate 8.07 ± 3.13 mL/min/1.73 m2). The pre- and post-tolvaptan 24-h UVs were significantly higher in patients not administered thiazide diuretics (1043.4 ± 645.6 vs. 1422.2 ± 774.0 mL/day; p < 0.001) than in those administered thiazide diuretics (1177.3 ± 686.5 vs. 1173.1 ± 629.1 mL/day; p = 0.93). In a multivariate regression model, thiazide diuretic use was significantly associated with decreased 24-h UV (β coefficient − 486.7, 95% confidence interval [CI] − 674.5 to − 298.8); increased urine osmolality (β coefficient 37.7, 95% CI 17.1–58.4); increased body weight (β coefficient 0.62, 95% CI 0.31–0.92); and increased 30-day dialysis initiation rate (odds ratio 3.40, 95% CI 1.18–9.82) after tolvaptan administration. Conclusions: Tolvaptan exhibited significant diuretic effects in patients with CHF, including those with severe renal dysfunction, which were diminished with concomitant thiazide diuretic use.

  • Late Dialysis Modality Education Could Negatively Predict Peritoneal Dialysis Selection

    Takashin Nakayama, Ken Nishioka, Kiyotaka Uchiyama, Kohkichi Morimoto, Ei Kusahana, Naoki Washida, Shintaro Yamaguchi, Tatsuhiko Azegami, Tadashi Yoshida, Hiroshi Itoh

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

    Corresponding author

     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.

  • High body mass index is a risk factor for transition to hemodialysis or hybrid therapy and peritoneal dialysis-related infection in Japanese patients undergoing peritoneal dialysis

    Eriko Yoshida Hama, Kiyotaka Uchiyama, Tomoki Nagasaka, Ei Kusahana, Takashin Nakayama, Itaru Yasuda, Kohkichi Morimoto, Naoki Washida, Hiroshi Itoh

    International Urology and Nephrology (Springer Science and Business Media LLC)   2022.06

    Corresponding author, Accepted,  ISSN  03011623

     View Summary

    Purpose: Obesity may negatively impact the clinical outcomes of patients undergoing peritoneal dialysis (PD). However, the impact of obesity on PD-related outcomes remains unclear. We herein examined the association of high body mass index (BMI) with complete hemodialysis (HD) transfer, transition to HD and PD/HD hybrid therapy, peritonitis, catheter exit-site and tunnel infection (ESI/TI), and heart failure-related hospitalization. Methods: This retrospective cohort study included 120 patients who underwent PD-catheter insertion between January 2008 and June 2018. BMI ≥ 25 kg/m2 at the time of PD-catheter insertion was defined as high BMI, and its association with outcomes was analyzed using the log-rank test and Cox proportional hazards models. Results: The follow-up duration was 46.2 (23.3–75.3) months. The time until transfer to HD and hybrid therapy was significantly shorter in the high BMI group than that in the low BMI group, whereas the time until HD transfer was not significantly different between the two groups (P < 0.001 and 0.18, respectively). Peritonitis-free and ESI/TI-free survivals were significantly shorter in the high BMI group than those in the low BMI group (P = 0.006 and 0.03, respectively). After adjusting for age, sex, diabetes mellitus, and estimated glomerular filtration rate, high BMI remained a significant risk factor for transferring to HD and hybrid therapy, peritonitis, and ESI/TI (hazard ratio [HR] 2.60, P < 0.001; HR 2.08, P = 0.01; HR 2.64, P = 0.02, respectively). Conclusion: BMI ≥ 25 kg/m2 is a risk factor for transition to HD and hybrid therapy, peritonitis, and ESI/TI, but not for complete HD transfer in Japanese patients with PD.

  • Health-Related Quality of Life Sleep Score Predicts Transfer to Hemodialysis among Patients on Peritoneal Dialysis

    Tomoki Nagasaka, Naoki Washida, Kiyotaka Uchiyama, Eriko Yoshida Hama, Ei Kusahana, Takashin Nakayama, Itaru Yasuda, Kohkichi Morimoto, Hiroshi Itoh

    Healthcare (MDPI AG)  10 ( 6 ) 1030 - 1030 2022.06

    Corresponding author

     View Summary

    Despite the superiority of peritoneal dialysis (PD) over hemodialysis (HD) regarding health-related quality of life (HRQOL), the specific HRQOL domain(s) that predict unplanned HD transfer remains uncertain. In this cohort study, we assessed the HRQOL of 50 outpatients undergoing PD using the Japanese version 1.3 Kidney Disease Quality of Life-Short Form from March 2017 to March 2018 and prospectively analyzed the association of each HRQOL component with HD transfer until June 2021. During the follow-up (41.5 (13.0–50.1) months), 21 patients were transferred to HD. In a multivariate Cox proportional hazards model adjusted for age, sex, PD vintage, urine output, Charlson comorbidity index, and incremental shuttle walking test, a higher sleep score was significantly associated with lower HD transfer rates (HR 0.70 per 10, p = 0.01). An adjusted subdistribution hazard model where elected transition to HD, death, and transplantation were considered competing events of unintended HD transfer that showed sleep score as an exclusive predictor of HD transfer (HR 0.70 per 10, p = 0.002). Our results suggest that sleep score among the HRQOL subscales is instrumental in predicting HD transfer in patients undergoing PD.

  • 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

    Ken Nishioka, Shintaro Yamaguchi, Itaru Yasuda, Norifumi Yoshimoto, Daiki Kojima, Kenji Kaneko, Mitsuhiro Aso, Tomoki Nagasaka, Eriko Yoshida, Kiyotaka Uchiyama, Takaya Tajima, Jun Yoshino, Tadashi Yoshida, Takeshi Kanda, Hiroshi Itoh

    Frontiers in Medicine (Frontiers Media SA)  9 2022.04

     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<sup>+</sup> 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.

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Reviews, Commentaries, etc. 【 Display / hide

  • Assisted PD - Latest Evidence and Issues in Japan

    Kiyotaka Uchiyama, Naoki Washida

    腎代替療法のすべて 92巻 ( 増刊号 ) 373 - 379 2022.06

    Lead author

  • ADPKDの治療:②非薬物治療(生活指導を中心に)

    内山 清貴

    腎臓内科 14 ( 5 ) 545 - 551 2021.11

    Lead author

  • 腎不全と腎代替療法 腹膜透析 14 腹膜透析の種類

    内山清貴, 鷲田直輝

    透析ケア  2021

    ISSN  1341-1489

  • 長期腹膜透析患者における、継続した腎代替療法選択の結果としての生体腎移植

    内山 清貴, 楊井 朱音, 北山 千草, 坂口 隆志, 高上 紀之, 小野 慶介, 前田 啓造, 上條 由佳, 栁 麻衣, 石橋 由孝

    腎と透析 腹膜透析2019 87巻別冊   176 - 177 2019.11

    Lead author

  • 長期腹膜透析後、生体腎移植を施行した高安動脈炎の一例

    楊井 朱音, 内山 清貴, 北山 千草, 坂口 隆志, 高上 紀之, 小野 慶介, 前田 啓造, 上條 由佳, 栁 麻衣, 石橋 由孝

    腎と透析 腹膜透析2019 87巻別冊   204 - 205 2019.11

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Awards 【 Display / hide

  • Young Investigator Award

    2022.06, Japanese Society of Anti-Aging Medicine, 慢性腎臓病における運動耐用能低下の意義および運動療法の有用性についての検討

  • Young Investigator Award

    2022.06, Keio University School of Medicine Alumni Association (Sanshikai), Home-based aerobic exercise and resistance training for severe chronic kidney disease: a randomized controlled trial

  • 優秀演題賞

    2019.06, 日本抗加齢医学会

  • YIA 会長賞(最優秀賞)

    2019.03, 日本腎臓リハビリテーション学会

  • 優秀演題(医師部門臨床研究)

    2018.10, 日本腹膜透析医学会

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Memberships in Academic Societies 【 Display / hide

  • 多発性嚢胞腎協会, 

    2022.06
    -
    Present
  • Japan Society of Human Genetics, 

    2022.05
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    Present
  • International Society for Peritoneal Dialysis, 

    2022.01
    -
    Present
  • 日本腎臓リハビリテーション学会, 

    2018.11
    -
    Present
  • 日本抗加齢医学会, 

    2018
    -
    Present

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Committee Experiences 【 Display / hide

  • 2019
    -
    Present

    疾患登録・調査研究分科会 多発性嚢胞腎ワーキンググループ, 厚生労働科学研究費補助金難治性疾患等政策研究事業(難治性疾患政策研究事業) 難治性腎障害に関する調査研究班

  • 2017
    -
    Present

    腹膜透析ガイドライン改訂ワーキンググループ(Systematic Review (SR)), 一般社団法人日本透析医学会