272 results on '"Motoshi Hattori"'
Search Results
202. Rituximab treatment for adult patients with focal segmental glomerulosclerosis
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Ken Tsuchiya, Takahito Moriyama, Daigo Kamei, Takashi Takei, Ayami Ochi, Keiko Uchida, Ari Shimizu, Kayu Nakayama, Shunji Shiohira, Chihiro Iwasaki, Yuki Tsuruta, Motoshi Hattori, Kosaku Nitta, Toshio Mochizuki, and Mitsuyo Itabashi
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Adult ,Male ,medicine.medical_specialty ,Nephrotic Syndrome ,Urology ,Lymphocyte Depletion ,Antibodies, Monoclonal, Murine-Derived ,Young Adult ,Focal segmental glomerulosclerosis ,Recurrence ,Internal Medicine ,Medicine ,Humans ,Young adult ,B-Lymphocytes ,Adult patients ,business.industry ,Glomerulosclerosis, Focal Segmental ,Glomerulosclerosis ,General Medicine ,medicine.disease ,Monoclonal ,Rituximab ,Female ,Steroids ,business ,Nephrotic syndrome ,DISEASE RELAPSE ,medicine.drug - Abstract
We present two cases with steroid-resistant nephrotic syndrome (SRNS) and two cases with steroid-dependent nephrotic syndrome (SDNS) due to focal segmental glomerulonephritis (FSGS) who were treated with a single dose of rituximab (375 mg/m(2)). Although the two cases with SRNS showed no response, the two cases with SDNS achieved complete remission. The patients in whom the peripheral B-cell counts subsequently increased after the administration of rituximab demonstrated a relapse. Rituximab may be an effective treatment agent for SDNS with FSGS and the peripheral B-cell count may be a useful marker in such patients for preventing disease relapse.
- Published
- 2012
203. A histologic classification of IgA nephropathy for predicting long-term prognosis: emphasis on end-stage renal disease
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Tetsuya Kawamura, Kensuke Joh, Hideo Okonogi, Kentaro Koike, Yasunori Utsunomiya, Yoichi Miyazaki, Masato Matsushima, Mitsuhiro Yoshimura, Satoshi Horikoshi, Yusuke Suzuki, Akira Furusu, Takashi Yasuda, Sayuri Shirai, Takanori Shibata, Masayuki Endoh, Motoshi Hattori, Ritsuko Katafuchi, Akinori Hashiguchi, Kenjiro Kimura, Seiichi Matsuo, Yasuhiko Tomino, and Special IgA Nephropathy Study Group
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Time Factors ,Adolescent ,medicine.medical_treatment ,Biopsy ,Kidney Glomerulus ,urologic and male genital diseases ,Gastroenterology ,Severity of Illness Index ,Nephropathy ,End stage renal disease ,Young Adult ,Japan ,Renal Dialysis ,Risk Factors ,Internal medicine ,Severity of illness ,medicine ,Odds Ratio ,Humans ,Risk factor ,Child ,Dialysis ,Aged ,Retrospective Studies ,Sclerosis ,medicine.diagnostic_test ,business.industry ,Glomerulosclerosis, Focal Segmental ,Retrospective cohort study ,Glomerulonephritis, IGA ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,Fibrosis ,Logistic Models ,Nephrology ,Child, Preschool ,Multivariate Analysis ,Disease Progression ,Kidney Failure, Chronic ,Female ,business - Abstract
A multicenter case-control study on IgA nephropathy (IgAN) was conducted to develop an evidence-based clinicopathologic classification of IgAN for predicting long-term renal outcome.Two hundred and eighty-seven patients including those with isolated hematuria or very mild proteinuria were enrolled. During a median follow-up of 9.3 years after biopsy, 49 patients (17%) progressed to end stage renal disease (ESRD). The associations between pathological variables and the need for chronic dialysis was examined by multivariate logistic regression analysis separately in patients who required dialysis earlier than 5 years (Early Progressors) and those who required dialysis within 5 to 10 years (Late Progressors) after biopsy.Independent pathological variables predicting progression to ESRD were global sclerosis, segmental sclerosis and fibrous crescents for Early Progressors, and global sclerosis and cellular/fibrocellular crescents for Late Progressors. Four histological grades, HG 1, HG 2, HG 3 and HG 4, were established corresponding to25%, 25-49%, 50-74% and =75% of glomeruli exhibiting cellular or fibrocellular crescents, global sclerosis, segmental sclerosis or fibrous crescents. Eleven (7%) patients in HG 1, 12 (16%) in HG 2, 13 (31%) in HG 3 and 13 (68%) in HG 4 progressed to ESRD. Multivariate logistic analysis revealed that the risk of progression to ESRD was significantly higher in HG 2, 3 and 4 than in HG 1 (odds ratio, 2.4, 5.7 and 27.6 vs. 1.0).Our evidence-based histologic classification can identify the magnitude of the risk of progression to ESRD and is useful for predicting long-term renal outcome in IgAN.
- Published
- 2012
204. Probucol Reduces Renal Injury in the ExHC Rat
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Yutaka Yamaguchi, Katsumi Ito, Hiroshi Kawaguchi, and Motoshi Hattori
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Electrophoresis ,Male ,medicine.medical_specialty ,Lipoproteins ,Hypercholesterolemia ,Kidney Glomerulus ,Probucol ,urologic and male genital diseases ,Rats, Sprague-Dawley ,Pathogenesis ,In vivo ,Internal medicine ,medicine ,Animals ,Foam cell ,Proteinuria ,urogenital system ,business.industry ,Macrophages ,Glomerulosclerosis ,Glomerulonephritis ,Lipid Metabolism ,medicine.disease ,Lipids ,Rats ,Cholesterol ,Endocrinology ,Food, Fortified ,lipids (amino acids, peptides, and proteins) ,medicine.symptom ,business ,Oxidation-Reduction ,Lipoprotein ,medicine.drug - Abstract
To investigate the potential roles of oxidized lipoproteins and glomerular macrophages in the pathogenesis of lipid-induced glomerular injury, we examined the effects of administration of probucol on the development of renal injury in ExHC rats. ExHC rats are derived from the Sprague-Dawley strain and are highly susceptible to dietary hypercholesterolemic stimuli. We reported previously that ExHC rats fed a cholesterol-supplemented diet (HCD) develop proteinuria and characteristic glomerular lesions. These lesions include marked accumulation of numerous lipid-filled foam cells, which have a surface marker that identifies them as macrophages, within mesangial regions, as well as segmental clusters of foam cells that are associated with capsular adhesions, the destruction of glomerular tufts and glomerular sclerosis. ExHC rats were maintained on an HCD or on an HCD supplemented with 5% (wt/wt) probucol for 8 weeks. Probucol reduced the extent of renal injury, as evidenced by proteinuria and segmental glomerular lesions, in ExHC rats fed an HCD, in the absence of any significant reduction in plasma cholesterol levels. Both low-density lipoprotein and beta-very-low density lipoprotein isolated from the plasma of probucol-treated rats were found to be resistant to oxidative modification by cupric ions. Both the size and the number of foam cells within glomeruli in the probucol-treated rats were significantly reduced as compared to those of foam cells in the untreated rats. Probucol might reduce renal injury in ExHC rats by limiting the oxidative modification of lipoproteins and, subsequently, by restricting the foam cell transformation of macrophages within glomeruli and by inhibiting the recruitment of macrophages into glomeruli. The results of the present study may be interpreted to indicate that local glomerular oxidative modification of lipoproteins might occur in vivo, and both oxidized lipoproteins and glomerular macrophages may play important roles in the pathogenesis of lipid-induced glomerular injury.
- Published
- 1994
205. Contents, Vol. 67, 1994
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L. Jeyaseelan, H. Chang, Bunshiro Akikusa, Michael M. Hirschl, A. Segarra, Shigeo Isaka, Karl M. Koch, Antonio Scalamogna, F. Kokot, Lucia Galli, K.S. Wong, Napoleone Prandini, Yasuharu Horie, S. Asano, Tamotsu Kaneko, Motoshi Hattori, G. Vreugdenhil, I.E. Tareyeva, Toshio Inada, N.N. Bogomolova, Pier Luigi Bedani, Dan Seidler, Katsumi Ito, Yuh-Feng Lin, L. Piera, Y.K. Lau, Cem Sungur, Fredric L. Coe, G.S.L. Lee, Ünal Yasavul, A. Cupisti, S. Giovannetti, G.S.C. Chiang, Ivan Hajdu, Masao Ohto, Hiroshi Kawaguchi, Alessandra Renieri, Shun-Yin Jan, Graziana Battini, V. Todorov, Amedeo F. De Vecchi, Nobuyoshi Takagi, A.J.G. Swaak, M. Meola, Tetuji Nishikawa, George John, Shiro Ueda, Takanobu Sakemi, Marco Seri, Sandro Mazzaferro, E. Franek, Ross R. Bailey, T. Kawamoto, J.L. Tovar, J. Myrta, Joost P.H. Drenth, Brett I. Shand, P. García Cosmes, T. Katoh, Yukichi Takamizawa, John H. Bauer, Anton N. Laggner, Juán Blanco, T. Nakamura, Paolo Gilli, Torsten Witte, George N. Marinides, Chakko K. Jacob, Toshikazu Takizawa, Anand Date, C.G. Winearls, Cristina Abbiati, Fumitaka Morito, Garry P. Reams, Mario De Marchi, R. Boneva, K.T. Woo, Junro Hori, Glen H. Murata, E.G. Nevraeva, Hisashi Oda, Oktay Özdemir, Kuo-Cheng Lu, Lucia Baiguini, Laura Torri Tarelli, Claudia Castelnovo, Paola Serbelloni, J.B. Levy, Isao Fukunishi, Yasushi Nakagawa, Jos W.M. Van der Meer, Susan K. Fellner, Hajime Toyoshima, Tomás Alburquerque, Sali Caglar, M.P. Ruiz-Valverde, W. Szewczyk, N. Ichikawa, T. Nagao, Christoph J. Olbricht, M. Jongen, C.H. Lim, W. Pawłowski, Makoto Ogawa, V. Minkova, J.C.M. Shastry, R.G. Filimonova, A.H. Tzamaloukas, Adalberto Sessa, Hidehisa Satta, F. Rubio, Cetin Turgan, Tekin Akpolat, Shang-Der Shieh, Masao Ishii, Elaine M. Worcester, Silvia Castellanta, Peter Sena, Leon A.M. Frenken, Luciano Feggi, Daniel Villarreal, Yutaka Yamaguchi, Giorgio Coen, A. Wiecek, Mietta Meroni, E. Buoncristiani, Bi-Lian Li, G. Barsotti, Eveline W. Wuis, K. Kurokawa, Osman Özcebe, M. Kokot, Sumi Tanaka, Naohiko Makino, A. Bar, León Vásquez, Osamu Tochikubo, Zhen Wu, Y.M. Chin, Pauling Chu, Reinoid O. Gans, and Anila Korula
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Traditional medicine ,business.industry ,Medicine ,business - Published
- 1994
206. Pretransplantation combined therapy with plasmapheresis and rituximab in a second living-related kidney transplant pediatric recipient with a very high risk for focal segmental glomerulosclerosis recurrence
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Hiroko, Chikamoto, Motoshi, Hattori, Nao, Kuroda, Yuko, Kajiho, Hideki, Matsumura, Hiroshi, Fujii, Kiyonobu, Ishizuka, Masataka, Hisano, Yuko, Akioka, Kandai, Nozu, Hiroshi, Kaito, and Maki, Shimizu
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Reoperation ,Time Factors ,Glomerulosclerosis, Focal Segmental ,Graft Survival ,Plasmapheresis ,Kidney Transplantation ,Antibodies, Monoclonal, Murine-Derived ,Treatment Outcome ,Disease Progression ,Living Donors ,Secondary Prevention ,Humans ,Immunologic Factors ,Female ,Renal Insufficiency ,Child ,Rituximab - Abstract
Prophylactic PP can provide some protection against post-transplantation recurrences of FSGS, but it cannot prevent recurrences in all cases. Therefore, new preventive therapies are needed. We report on a 7.9-yr-old girl treated with pretransplantation prophylactic combined therapy consisting of four sessions of PP and one dose of rituximab before a second living-related KTX. The patient had a very high risk of post-transplantation FSGS recurrence because this had occurred after the first KTX. During the 36 months since the second transplantation, she has had no evidence of proteinuria or significant infectious complications. Although our experience is too preliminary to draw any generalizable conclusions, pretransplantation combined therapy with PP and rituximab might be a possible option for the prevention of FSGS recurrence in very high-risk recipients undergoing living-donor KTXs.
- Published
- 2011
207. Epstein-Barr virus load for early detection of lymphoproliferative disorder in pediatric renal transplant recipients
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Akihiko Maeda, Yuko Akioka, Masataka Hisano, Hiroko Chikamoto, Motoshi Hattori, Masayuki Ishihara, Sumitaka Dohno, E Tanaka, Mikiya Fujieda, Takayuki Sato, and Hiroshi Wakiguchi
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Male ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,Adolescent ,medicine.disease_cause ,Asymptomatic ,Antiviral Agents ,Polymerase Chain Reaction ,Post-transplant lymphoproliferative disorder ,Herpesviridae ,hemic and lymphatic diseases ,Medicine ,Gammaherpesvirinae ,Humans ,Child ,biology ,business.industry ,General Medicine ,Viral Load ,medicine.disease ,biology.organism_classification ,Epstein–Barr virus ,Kidney Transplantation ,Lymphoproliferative Disorders ,Transplantation ,Nephrology ,Child, Preschool ,Immunology ,Female ,Viral disease ,medicine.symptom ,business ,Viral load ,Immunosuppressive Agents - Abstract
Aim: The aims of this study were to establish a protocol for monitoring Epstein-Barr virus (EBV) infection for identification of pediatric renal transplant recipients with a high risk of developing posttransplant lymphoproliferative disorder (PTLD) and to predict the development of PTLD. Subjects and methods: Peripheral blood mononuclear cells (PBMCs) and plasma EBV loads were measured by nested PCR (n-PCR) and real-time PCR (r-PCR) every 1- 3 months after grafting in 17 pediatric recipients who were seronegative for EBV before grafting (4 with EBV-associated symptoms, including 2 with PTLD (Group A); 6 with asymptomatic persistent high EBV loads in PBMCs of > 1,000 copies/μgDNA for over 6 months (Group B); and 7 with neither EBV-associated symptoms nor persistent high EBV loads in PBMCs (Group C)). Results: n-PCR revealed EBV-DNA in PBMCs from all patients. The EBV genome was present in plasma in 3 (75%), 1 (17%), and 0 (0%) in Groups A, B and C (p < 0.01 for A vs. B and A vs. C). EBV loads detected by r-PCR in PBMCs were significantly higher in Groups A (p < 0.05) and B (p < 0.01) compared to Group C. EBV genomes in plasma were detected by n- and r-PCR in only the 2 cases with PTLD. One patient with lymphadenitis in Group A and 1 patient in Group B had EBV-DNA in plasma based on n-PCR, but the viral loads using r-PCR were < 250 copies/ml. Conclusion: EBV loads in PBMCs alone are insufficient for predicting EBV-associated symptoms including PTLD. Plasma EBV loads (over 250 copies/ml) estimated by r-PCR may be useful to distinguish PTLD from other EBV-associated diseases or asymptomatic viremia.
- Published
- 2011
208. Medullary ray injury in renal allografts
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Akimitsu, Kobayashi, Izumi, Yamamoto, Shinichi, Ito, Yuko, Akioka, Hiroyasu, Yamamoto, Satoshi, Teraoka, Motoshi, Hattori, Kazunari, Tanabe, Tatsuo, Hosoya, and Yutaka, Yamaguchi
- Subjects
Adult ,Inflammation ,Male ,Humans ,Female ,Kidney ,Fibrosis ,Kidney Transplantation ,Statistics, Nonparametric - Abstract
Non-immune injury leading to interstitial fibrosis and tubular atrophy (IF/TA) in renal allografts has various etiologies, but pathological means of verification have yet to be developed. Medullary ray injury (MRI) is a pathological feature of many non-immune injuries inducing IF/TA and pathological determination of calcineurin inhibitor (CNI) toxicity proceeding to striped fibrosis. We investigated the contribution of CNI toxicity to MRI and other non-immune etiologies related to IF/TA. In this study MRI is defined as fibrosis and inflammation localized exclusively to the medullary ray. Thirty-six protocol biopsies showing MRI were analyzed and classified histopathologically as following: MRI related to CNI toxicity; chronic obstruction or reflux nephropathy; and acute or chronic pyelonephritis. The etiology of MRI was CNI toxicity (n= 16, 44.4%), chronic obstruction (n= 13, 36.1%), acute or chronic pyelonephritis (n= 2, 5.6%), and other (n= 5, 13.9%). We performed cystography in seven cases of MRI related to chronic obstruction or reflux nephropathy and six cases showing vesicoureteral reflux. The ci+ct score showed significant progression after one year in 30 of the 36 cases (1.53 ± 1.04 vs. 3.03 ± 1.13, P0.01). MRI has various etiologies and may also predict changes in urological complications. The classification of MRI may be useful to determine the non-immune etiology leading to IF/TA.
- Published
- 2010
209. 2008 Japanese Society for Dialysis Therapy: guidelines for renal anemia in chronic kidney disease
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Yoshiharu, Tsubakihara, Shinichi, Nishi, Takashi, Akiba, Hideki, Hirakata, Kunitoshi, Iseki, Minoru, Kubota, Satoru, Kuriyama, Yasuhiro, Komatsu, Masashi, Suzuki, Shigeru, Nakai, Motoshi, Hattori, Tetsuya, Babazono, Makoto, Hiramatsu, Hiroyasu, Yamamoto, Masami, Bessho, and Tadao, Akizawa
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Adult ,Male ,Hemoglobins ,Japan ,Renal Dialysis ,Practice Guidelines as Topic ,Hematinics ,Humans ,Kidney Failure, Chronic ,Anemia ,Female ,Child ,Erythropoietin - Abstract
The Japanese Society for Dialysis Therapy (JSDT) guideline committee, chaired by Dr Y. Tsubakihara, presents the Japanese guidelines entitled "Guidelines for Renal Anemia in Chronic Kidney Disease." These guidelines replace the "2004 JSDT Guidelines for Renal Anemia in Chronic Hemodialysis Patients," and contain new, additional guidelines for peritoneal dialysis (PD), non-dialysis (ND), and pediatric chronic kidney disease (CKD) patients. Chapter 1 presents reference values for diagnosing anemia that are based on the most recent epidemiological data from the general Japanese population. In both men and women, hemoglobin (Hb) levels decrease along with an increase in age and the level for diagnosing anemia has been set at13.5 g/dL in males and11.5 g/dL in females. However, the guidelines explicitly state that the target Hb level in erythropoiesis stimulating agent (ESA) therapy is different to the anemia reference level. In addition, in defining renal anemia, the guidelines emphasize that the reduced production of erythropoietin (EPO) that is associated with renal disorders is the primary cause of renal anemia, and that renal anemia refers to a condition in which there is no increased production of EPO and serum EPO levels remain within the reference range for healthy individuals without anemia, irrespective of the glomerular filtration rate (GFR). In other words, renal anemia is clearly identified as an "endocrine disease." It is believed that defining renal anemia in this way will be extremely beneficial for ND patients exhibiting renal anemia despite having a high GFR. We have also emphasized that renal anemia may be treated not only with ESA therapy but also with appropriate iron supplementation and the improvement of anemia associated with chronic disease, which is associated with inflammation, and inadequate dialysis, another major cause of renal anemia. In Chapter 2, which discusses the target Hb levels in ESA therapy, the guidelines establish different target levels for hemodialysis (HD) patients than for PD and ND patients, for two reasons: (i) In Japanese HD patients, Hb levels following hemodialysis rise considerably above their previous levels because of ultrafiltration-induced hemoconcentration; and (ii) as noted in the 2004 guidelines, although 10 to 11 g/dL was optimal for long-term prognosis if the Hb level prior to the hemodialysis session in an HD patient had been established at the target level, it has been reported that, based on data accumulated on Japanese PD and ND patients, in patients without serious cardiovascular disease, higher levels have a cardiac or renal function protective effect, without any safety issues. Accordingly, the guidelines establish a target Hb level in PD and ND patients of 11 g/dL or more, and recommend 13 g/dL as the criterion for dose reduction/withdrawal. However, with the results of, for example, the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) study in mind, the guidelines establish an upper limit of 12 g/dL for patients with serious cardiovascular disease or patients for whom the attending physician determines high Hb levels would not be appropriate. Chapter 3 discusses the criteria for iron supplementation. The guidelines establish reference levels for iron supplementation in Japan that are lower than those established in the Western guidelines. This is because of concerns about long-term toxicity if the results of short-term studies conducted by Western manufacturers, in which an ESA cost-savings effect has been positioned as a primary endpoint, are too readily accepted. In other words, if the serum ferritin is100 ng/mL and the transferrin saturation rate (TSAT) is20%, then the criteria for iron supplementation will be met; if only one of these criteria is met, then iron supplementation should be considered unnecessary. Although there is a dearth of supporting evidence for these criteria, there are patients that have been surviving on hemodialysis in Japan for more than 40 years, and since there are approximately 20 000 patients who have been receiving hemodialysis for more than 20 years, which is a situation that is different from that in many other countries. As there are concerns about adverse reactions due to the overuse of iron preparations as well, we therefore adopted the expert opinion that evidence obtained from studies in which an ESA cost-savings effect had been positioned as the primary endpoint should not be accepted unquestioningly. In Chapter 4, which discusses ESA dosing regimens, and Chapter 5, which discusses poor response to ESAs, we gave priority to the usual doses that are listed in the package inserts of the ESAs that can be used in Japan. However, if the maximum dose of darbepoetin alfa that can currently be used in HD and PD patients were to be used, then the majority of poor responders would be rescued. Blood transfusions are discussed in Chapter 6. Blood transfusions are attributed to the difficulty of managing renal anemia not only in HD patients, but also in end-stage ND patients who respond poorly to ESAs. It is believed that the number of patients requiring transfusions could be reduced further if there were novel long-acting ESAs that could be used for ND patients. Chapter 7 discusses adverse reactions to ESA therapy. Of particular concern is the emergence and exacerbation of hypertension associated with rapid hematopoiesis due to ESA therapy. The treatment of renal anemia in pediatric CKD patients is discussed in Chapter 8; it is fundamentally the same as that in adults.
- Published
- 2010
210. Japan Renal Biopsy Registry: the first nationwide, web-based, and prospective registry system of renal biopsies in Japan
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Masataka Honda, Michio Nagata, Tamaki Sasaki, Norishige Yoshikawa, Shoji Kagami, Yukio Yuzawa, Hitoshi Yokoyama, Hitoshi Sugiyama, Takao Saito, Hiroshi Sato, Takashi Taguchi, Motoshi Hattori, Shinichi Nishi, Kazumasa Oka, Kensuke Joh, Kazuhiko Tsuruya, Yutaka Kiyohara, Hideyasu Kiyomoto, Hiroyuki Iida, Makoto Higuchi, Hirofumi Makino, Kunio Morozumi, Seiichi Matsuo, Yukimasa Kohda, Tetsuya Kawamura, Atsushi Fukatsu, and Yuichiro Fukasawa
- Subjects
Nephrology ,Adult ,Male ,medicine.medical_specialty ,Nephrotic Syndrome ,Adolescent ,Physiology ,Biopsy ,urologic and male genital diseases ,Kidney ,Glomerulonephritis, Membranous ,Japan ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Registries ,Child ,Aged ,Aged, 80 and over ,Internet ,medicine.diagnostic_test ,business.industry ,Renal vascular disease ,Infant ,Glomerulonephritis, IGA ,Middle Aged ,Kidney Transplantation ,Cross-Sectional Studies ,Child, Preschool ,Kidney Failure, Chronic ,Female ,Kidney Diseases ,National registry ,Renal biopsy ,business - Abstract
The Committee for the Standardization of Renal Pathological Diagnosis and the Working Group for Renal Biopsy Database of the Japanese Society of Nephrology started the first nationwide, web-based, and prospective registry system, the Japan Renal Biopsy Registry (J-RBR), to record the pathological, clinical, and laboratory data of renal biopsies in 2007.The patient data including age, gender, laboratory data, and clinical and pathological diagnoses were recorded on the web page of the J-RBR, which utilizes the system of the Internet Data and Information Center for Medical Research in the University Hospital Medical Information Network. We analyzed the clinical and pathological diagnoses registered on the J-RBR in 2007 and 2008.Data were collected from 818 patients from 18 centers in 2007 and 1582 patients from 23 centers in 2008, including the affiliated hospitals. Renal biopsies were obtained from 726 native kidneys (88.8%) and 92 renal grafts (11.2%) in 2007, and 1400 native kidneys (88.5%) and 182 renal grafts (11.5%) in 2008. The most common clinical diagnosis was chronic nephritic syndrome (47.4%), followed by nephrotic syndrome (16.8%) and renal transplantation (11.2%) in 2007. A similar frequency of the clinical diagnoses was recognized in 2008. Of the native kidneys, the most frequent pathological diagnosis as classified by pathogenesis was immunoglobulin (Ig) A nephropathy (IgAN) both in 2007 (32.9%) and 2008 (30.2%). Among the primary glomerular diseases (except IgAN), membranous nephropathy (MN) was the most common disease both in 2007 (31.4%) and 2008 (25.7%).In a cross-sectional study, the J-RBR has shown IgAN to be the most common disease in renal biopsies in 2007 and 2008, consistent with previous Japanese studies. MN predominated in the primary glomerular diseases (except for IgAN). The frequency of the disease and the clinical and demographic correlations should be investigated in further analyses by the J-RBR.
- Published
- 2010
211. De novo membranous nephropathy and antibody-mediated rejection in transplanted kidney
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Kazuho, Honda, Shigeru, Horita, Daisuke, Toki, Sekiko, Taneda, Kosaku, Nitta, Motoshi, Hattori, Kazunari, Tanabe, Satoshi, Teraoka, Hideaki, Oda, and Yutaka, Yamaguchi
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Adult ,Graft Rejection ,Male ,Young Adult ,Isoantibodies ,Case-Control Studies ,Fluorescent Antibody Technique ,Humans ,Female ,Middle Aged ,Glomerulonephritis, Membranous ,Kidney Transplantation - Abstract
The etiology of de novo membranous nephropathy (MN) after kidney transplantation is still uncertain. Immunological response to various allograft antigens is speculated to be a candidate for the etiology.Seventeen patients with post-transplant de novo MN were studied clinically and pathologically in comparison with control post-transplant patients without MN. Double immunofluorescent staining was performed to identify the presence of donor-specific human leukocyte antigen (HLA) combined with IgG in the deposits on glomerular capillary walls.De novo MN occurs in relatively late period after transplantation (102.1 ± 68.3 months), presenting various degree of proteinuria. Histological findings associated with antibody-mediated rejection (AMR), such as peritubular capillaritis and C4d deposition in peritubular capillary, were more frequently observed in the patients with de novo MN than the non-MN control patients. Donor-specific antibody (DSA) was detected in five patients at the time of biopsy. In one case of de novo MN with DSA, a donor-derived HLA was identified in the subepithelial deposits on the glomerular capillary walls combined with IgG deposition.DSA and AMR might play some roles for the pathogenesis in some patients with de novo MN after kidney transplantation.
- Published
- 2010
212. Clinicopathological study of childhood IgA nephropathy fallen into chronic renal failure
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Motoshi Hattori, Reiko Kubota, Katsumi Ito, Keiko Ito, Yuri Tsunoda, Masatoshi Tokuyama, Yutaka Yamaguchi, Miyuki Kohno, Yumiko Takeda, and Hiroshi Kawaguchi
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medicine.medical_specialty ,Pathology ,business.industry ,Internal medicine ,Chronic renal failure ,Medicine ,business ,medicine.disease ,Gastroenterology ,Nephropathy - Published
- 1992
213. A peculiar vacuolization in the kidney transplant of a child treated with tacrolimus
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Shigeru Horita, Naoko Matsumoto, Motoshi Hattori, Katsumi Ito, Kazunari Tanabe, Yutaka Yamaguchi, Hiroshi Shiraga, Makiko Oonishi, Toshiaki Suzuki, Hiroko Chikamoto, Seiji Watanabe, Hiroshi Toma, and Tadahiko Tokumoto
- Subjects
Transplantation ,medicine.medical_specialty ,Pathology ,Transplant biopsy ,Kidney ,business.industry ,chemical and pharmacologic phenomena ,Kidney transplant ,Gastroenterology ,Tacrolimus ,Nephrotoxicity ,medicine.anatomical_structure ,Vacuolization ,Internal medicine ,Toxicity ,medicine ,business - Abstract
Tacrolimus (TAC) is a useful immunosuppressive agent in the prevention of rejection. However, the blood level between its therapeutic and toxic levels is narrow such that its nephrotoxicity is a problem. Moreover, its bioavailability and pharmakokinetics are highly variable. We experienced a case of acute nephrotoxicity, in which the blood level rose about 10 times above the expected level. We found a peculiar vacuolization in the transplant biopsy specimen. This change showed a marked vacuolization of the tubular cells, suggestive of acute nephrotoxicity by TAC.
- Published
- 2000
214. CKD Clinical Practice Guidebook. The essence of treatment for CKD patients
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Yasuhiro, Ando, Sadayoshi, Ito, Osamu, Uemura, Tetsuo, Kato, Genjiro, Kimura, Toshiyuki, Nakao, Motoshi, Hattori, Masafumi, Fukagawa, Masaru, Horio, and Tetsuya, Mitarai
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Humans ,Kidney Failure, Chronic - Published
- 2009
215. Monitoring of Epstein-Barr virus load and killer T cells in pediatric renal transplant recipients
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Yuko Akioka, Hiroko Chikamoto, Akihiko Maeda, E Tanaka, Sumitaka Dohno, Masataka Hisano, Takayuki Sato, Motoshi Hattori, Hiroshi Wakiguchi, Y Ishiura, M Miyamura, and Mikiya Fujieda
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Graft Rejection ,Male ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,Adolescent ,medicine.disease_cause ,Antibodies, Viral ,Asymptomatic ,Polymerase Chain Reaction ,Post-transplant lymphoproliferative disorder ,Herpesviridae ,hemic and lymphatic diseases ,medicine ,Cytotoxic T cell ,Humans ,Peripheral blood cell ,Child ,Retrospective Studies ,business.industry ,General Medicine ,Viral Load ,medicine.disease ,Natural killer T cell ,Prognosis ,Kidney Transplantation ,Transplantation ,Nephrology ,Child, Preschool ,Immunology ,DNA, Viral ,Natural Killer T-Cells ,Female ,medicine.symptom ,business ,CD8 ,Immunosuppressive Agents ,Follow-Up Studies - Abstract
Aim: The aim of this study is to establish a monitoring method to prevent Epstein-Barr virus (EBV)-associated symptoms including post-transplant lymphoproliferative disorder (PTLD) that occur after pediatric renal transplantation. Subjects and methods: Circulating EBV loads were quantified by real-time PCR every 1 - 3 months after grafting in 22 pediatric recipients (13 EBV-seronegative [R(-)] and 9 EBV-seropositive [R(+)] recipients before grafting). The peripheral blood cell populations of non-specific activated killer cells (CD8 + HLA-DR + phenotype) in 13 R(-) recipients and EBV-specific cytotoxic T cells (CTLs) reactive with a tetramer expressing HLA-A24-restricted EBV-specific antigens in 8 of 13 R(-) recipients were determined by flow cytometry. Results: EBV-associated symptoms including PTLD (2 cases) were found in 4 R(-) and none of the R(+) recipients. The maximum of EBV load in the R(-) group was significantly higher that in the R(+) group. In R(-) recipients, 4 symptomatic cases had significantly more EBV genome than asymptomatic cases. EBV-specific CTLs were detected in 6 of the 8 R(-) recipients, but these CTLs could not be detected in 1 of the 2 cases at onset of PTLD. The percentage of CD8 + HLA-DR + cells was significantly higher in asymptomatic recipients than in recipients with EBV-associated symptoms whose EBV loads were over 400 copies/μg DNA. Conclusion: Monitoring of killer T cells and EBV loads may allow assessment of the risk of EBV-associated symptoms, and high EBV loads and low EBV-specific and/or non-specific CTL responses may be predictive for development of EBV-associated symptoms such as PTLD.
- Published
- 2008
216. Increase of integrin-linked kinase activity in cultured podocytes upon stimulation with plasma from patients with recurrent FSGS
- Author
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Hiroyasu Tsukaguchi, Motoshi Hattori, Hiroko Chikamoto, Koichiro Tsuchiya, Naoto Kobayashi, Yuko Akioka, Shoji Kagami, and Maki Shimizu
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Cell Culture Techniques ,Protein Serine-Threonine Kinases ,urologic and male genital diseases ,Podocyte ,Mice ,Plasma ,Focal segmental glomerulosclerosis ,Laminin ,Recurrence ,Internal medicine ,Immunology and Allergy ,Medicine ,Animals ,Humans ,Pharmacology (medical) ,Integrin-linked kinase ,Child ,Transplantation ,biology ,urogenital system ,business.industry ,Glomerulosclerosis, Focal Segmental ,Podocytes ,Glomerulosclerosis ,Infant ,Glomerulonephritis ,medicine.disease ,female genital diseases and pregnancy complications ,Immune complex ,Endocrinology ,medicine.anatomical_structure ,Child, Preschool ,embryonic structures ,biology.protein ,Cancer research ,Female ,business - Abstract
Recurrent focal segmental glomerulosclerosis (FSGS) is a major challenge in the field of transplantation. Integrin-linked kinase (ILK) has emerged as a key mediator of podocyte-glomerular basement membrane (GBM) interactions. To clarify the involvement of plasma factors in FSGS recurrence, we examined the effects of plasma from FSGS patients with or without posttransplant recurrence on cultured podocytes, focusing particularly on ILK activity. Podocytes from a conditionally immortalized mouse podocyte cell line were treated with plasma from 11 FSGS patients, and ILK activity was determined using an immune complex kinase assay. Treatment with plasma from three patients with recurrence induced an increase in ILK activity. In contrast, no increase in ILK activity was observed in cultured podocytes treated with plasma from the remaining three patients with recurrence and five patients without recurrence. Cultured podocytes treated with plasma that induced ILK activity showed alterations of focal contact and detachment from the laminin matrix. In conclusion, this preliminary study provides experimental evidence suggesting the possible presence of circulating toxic factors in the plasma of some patients with recurrent FSGS, which induce an increase in podocyte ILK activity that may lead to the detachment of podocytes from the GBM.
- Published
- 2008
217. Elevated urinary plasmin activity resistant to alpha2-antiplasmin in acute poststreptococcal glomerulonephritis
- Author
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Tetsuzo Sugisaki, Soichiro Miura, Nobuyuki Yoshizawa, Koichi Matsumoto, Toshihiro Sawai, Muneharu Yamada, Shigenobu Suzuki, Yuichi Kikuchi, Kikuko Tamura, Motoshi Hattori, Takashi Oda, and Tamehachi Namikoshi
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,Receptors, Peptide ,Plasmin ,Urinary system ,Urine ,chemistry.chemical_compound ,Glomerulonephritis ,Alpha 2-antiplasmin ,Internal medicine ,Streptococcal Infections ,medicine ,Humans ,Zymography ,Fibrinolysin ,Child ,Transplantation ,Creatinine ,alpha-2-Antiplasmin ,business.industry ,Glomerulonephritis, IGA ,Middle Aged ,medicine.disease ,Endocrinology ,chemistry ,Nephrology ,Case-Control Studies ,Child, Preschool ,Acute Disease ,business ,Plasminogen activator ,Biomarkers ,medicine.drug - Abstract
BACKGROUND: A pathogenic role of intraglomerular plasmin bound to nephritogenic antigen (nephritis-associated plasmin receptor, NAPlr) and resistant to physiologic inhibitors such as alpha(2)-antiplasmin (alpha(2)-AP) has recently been proposed in acute poststreptococcal glomerulonephritis (APSGN). To confirm this concept, we analysed the urinary profile of plasmin cascade in APSGN patients. METHODS: Urine samples from 10 patients with APSGN, 12 patients with IgA nephropathy (IgAN), 10 patients with streptococcal infection without nephritis (SI) and 10 healthy control subjects were analysed. The alpha(2)-AP-resistant plasmin activity was assessed by a chromogenic assay after alpha(2)-AP was added to each urine sample. Urinary plasminogen activator (PA) and plasmin were further analysed by polyacrylamide gel zymography. Urinary NAPlr was assessed by western blot analysis in selected samples. RESULTS: Urinary alpha(2)-AP-resistant plasmin activity corrected for creatinine concentration (units/g x creatinine) was significantly higher in patients with APSGN (2.99 +/- 0.63) than in patients with IgAN (1.02 +/- 0.20, P < 0.01), SI (0.79 +/- 0.17, P < 0.01), or in healthy control subjects (0.73 +/- 0.18, P < 0.01). This tendency was confirmed by casein gel zymography. However urinary PA activity assessed by plasminogen-casein gel zymography did not differ between groups. NAPlr was detected in the urine of APSGN patients. CONCLUSIONS: We found elevated urinary plasmin activity resistant to alpha(2)-AP, which may be due to urinary excretion of NAPlr in patients with APSGN. This result supports the pathogenic role of the NAPlr-plasmin complex in the development of APSGN. Furthermore, alpha(2)-AP-resistant urinary plasmin activity may be useful as a diagnostic marker for APSGN.
- Published
- 2008
218. Clinical features and mutational survey of NPHS2 (podocin) in Japanese children with focal segmental glomerulosclerosis who underwent renal transplantation
- Author
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Yuko Akioka, Daisuke Ogino, Hyogo Nakakura, Akiko Kitamura, Takeki Furue, Kenichiro Miura, Hiroko Chikamoto, Kazuhiro Takahashi, Takashi Sakano, Hiroyasu Tsukaguchi, Akira Ashida, Motoshi Hattori, Masataka Hisano, and Tae Oomori
- Subjects
Nephrology ,Male ,medicine.medical_specialty ,Pathology ,DNA Mutational Analysis ,Consanguinity ,urologic and male genital diseases ,Gastroenterology ,Pathogenesis ,Primary FSGS ,Focal segmental glomerulosclerosis ,Japan ,Recurrence ,Internal medicine ,medicine ,Humans ,Family history ,Child ,Transplantation ,Alanine ,Polymorphism, Genetic ,biology ,business.industry ,Glomerulosclerosis, Focal Segmental ,Intracellular Signaling Peptides and Proteins ,Membrane Proteins ,medicine.disease ,Kidney Transplantation ,female genital diseases and pregnancy complications ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Mutation ,Podocin ,biology.protein ,Female ,business ,Immunosuppressive Agents - Abstract
Recurrent FSGS is a major challenge in the field of nephrology. To clarify the role of NPHS2 defects in the pathogenesis of FSGS recurrence, we sequenced all eight exons of NPHS2 in 11 Japanese pediatric FSGS patients with or without post-transplant recurrence. All patients had biopsy-proven primary FSGS, had no family history of renal diseases or consanguinity, were steroid-resistant, and received living-related renal transplantation. The mean age at onset was 5.0 +/- 3.1 yr and mean age at renal transplantation was 10.4 +/- 4.1 yr. Mutational analysis of NPHS2 was performed using polymerase chain reaction and direct sequencing. We found a synonymous T/C polymorphism at alanine 318 (GCC to GCT) in seven of 11 patients but no other causative NPHS2 mutations. FSGS recurred immediately after transplant in seven patients, while the remaining four patients had no recurrence for 3.2-5.8 yr. There were no differences between recurrent and non-recurrent patients in the onset age and the interval from onset to ESRD. In conclusion, we detected no causative NPHS2 mutations in Japanese pediatric FSGS patients with or without post-transplant recurrence. Further studies on the involvement of other genes are required to better understand recurrent FSGS.
- Published
- 2008
219. [Dietary recommendations for chronic kidney disease, 2007]
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Toshiyuki, Nakao, Tsutomu, Sanaka, Yoshiharu, Tsubakihara, Motoshi, Hattori, Masataka, Honda, Sonoo, Mizuiri, Yuzo, Watanabe, Yoshie, Kanazawa, and Takeo, Kanno
- Subjects
Adult ,Aged, 80 and over ,Male ,Adolescent ,Infant ,Potassium, Dietary ,Sodium, Dietary ,Middle Aged ,Reference Standards ,Severity of Illness Index ,Nutrition Policy ,Renal Dialysis ,Child, Preschool ,Chronic Disease ,Humans ,Female ,Kidney Diseases ,Dietary Proteins ,Child ,Energy Intake ,Peritoneal Dialysis ,Aged - Published
- 2008
220. Screening for Proteinuria and Hematuria in School Children—Is It Possible to Reduce the Incidence of Chronic Renal Failure in Children and Adolescents?
- Author
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Katsumi Ito, Motoshi Hattori, and Hiroshi Kawaguchi
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Population ,Lupus nephritis ,Disease ,Nephropathy ,Japan ,medicine ,Humans ,Mass Screening ,Child ,education ,Mass screening ,Hematuria ,education.field_of_study ,Proteinuria ,business.industry ,Incidence ,Incidence (epidemiology) ,medicine.disease ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Kidney Failure, Chronic ,Chronic renal failure ,Female ,medicine.symptom ,business - Abstract
In this study we evaluated the incidence of chronic renal failure in children with asymptomatic proteinuria and/or hematuria detected by a mass screening program in school and kindergarten. A total of four thousand and three children, aged from 2 to 18 years old was referred to our institute between 1977 and 1990. Of them, 4 cases were AGN, 8 cases Alports' syndrome, 7 cases FGN, 7 cases F(s)GS, 3 cases HSPN, 148 cases IgA nephropathy, 12 cases MN, 24 cases MPGN (including 7 cases of focal type MPGN), 1 case lupus nephritis, and others. Of these children 2 of 8 cases of Alports' syndrome, one of 7 cases of FGS, 6 of 148 cases of IgA nephropathy and none of 24 cases of MPGN developed chronic renal failure. It is true that the incidence of chronic renal failure in children with various kinds of renal disease detected by a mass screening program is lower than that of symptomatic children. However, since we do not have yet any specific treatment in most cases and also since the follow-up period is not long enough, the definite conclusion that a mass screening program can alter the prognosis of children with renal diseases cannot be drawn except for some particular lesions such as MPGN, especially the focal type. Further study including a much larger population of patients is necessary.
- Published
- 1990
221. Epstein-Barr virus DNA load and seroconversion in pediatric renal transplantation with tacrolimus immunosuppression
- Author
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Makoto Uchiyama, Motoshi Hattori, Kota Takahashi, Hiroshi Shiraga, Toshiaki Suzuki, Soichiro Okubo, and Yohei Ikezumi
- Subjects
Male ,medicine.medical_specialty ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,medicine.medical_treatment ,Gastroenterology ,Methylprednisolone ,Polymerase Chain Reaction ,Tacrolimus ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Living Donors ,Humans ,Seroconversion ,Child ,Kidney transplantation ,Antibacterial agent ,Transplantation ,Kidney ,business.industry ,Immunosuppression ,Mycophenolic Acid ,Viral Load ,medicine.disease ,Kidney Transplantation ,Lymphoproliferative Disorders ,Surgery ,surgical procedures, operative ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,DNA, Viral ,Female ,business ,Viral load ,Immunosuppressive Agents - Abstract
EBV infection is one of major complications arising in pediatric patients who have undergone renal transplantation. A strong correlation between the grade of immunosuppression and the development of PTLD, one of the most severe EBV-associated diseases, has been recognized. In this study, we monitored the serologic profile in conjunction with peripheral blood EBV-DNA load of 32 children who underwent renal transplantation with tacrolimus as an immunosuppressant. Six patients were EBV-seronegative (EBV−) before the transplantation, and the mean DNA load in the EBV− group was significantly higher than that in the EBV-seropositive (EBV+) group. Seroconversion occurred in five of these patients in a mean period of 22 weeks after the transplantation. The EBV-DNA load in the EBV+ group was maintained at a low level for a year, whereas it increased rapidly to over 1 × 105 copies/mL in two patients in the EBV− group three to seven months after the transplantation, which corresponds to the timing of seroconversion, and one of them developed PTLD. These observations suggest that the close monitoring of the EBV-DNA load, along with longitudinal observation of seroconversion, is essential in pediatric renal transplantation, particularly for younger children who are more likely to be EVB−.
- Published
- 2007
222. [Lipid-induced glomerular injury]
- Author
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Motoshi, Hattori
- Subjects
Nephrotic Syndrome ,Kidney Glomerulus ,Lipid Metabolism Disorders ,Humans ,Kidney Diseases - Published
- 2007
223. [Recent advances in therapy for nephrotic syndrome in children]
- Author
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Motoshi, Hattori
- Subjects
Risk ,Nephrotic Syndrome ,Recurrence ,Prednisolone ,Azathioprine ,Anti-Inflammatory Agents ,Humans ,Chlorambucil ,Child ,Cyclophosphamide ,Drug Administration Schedule ,Immunosuppressive Agents ,Follow-Up Studies - Published
- 2007
224. SPECT/CT to diagnose pleuroperitoneal communication-associated hydrothorax in peritoneal dialysis
- Author
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Kiyonobu Ishizuka, Shoichiro Kanda, Yuko Akioka, Kei Nishiyama, Motoshi Hattori, Kenji Fukushima, Hiroko Chikamoto, Noriko Sugawara, Takayuki Miyai, and Tohaku Jo
- Subjects
Male ,medicine.medical_specialty ,Pleural effusion ,medicine.medical_treatment ,Hydrothorax ,Peritoneal Diseases ,Scintigraphy ,Pleuroperitoneal ,Peritoneal dialysis ,Young Adult ,medicine ,Humans ,Hypoalbuminemia ,Tomography, Emission-Computed, Single-Photon ,medicine.diagnostic_test ,business.industry ,Pleural Diseases ,medicine.disease ,Diaphragm (structural system) ,Transplantation ,Nephrology ,Kidney Failure, Chronic ,Radiology ,business ,Peritoneal Dialysis - Abstract
A 19-year-old man with end-stage renal failure secondary to bilateral hypoplastic kidney received nightly automated peritoneal dialysis (PD). Three months after starting PD, he complained of dyspnea. Chest X-ray showed right-sided pleural effusion (Figure 1). Congestive cardiac failure, hypoalbuminemia, and fluid overload were ruled out, so pleuroperitoneal communication (PPC) was suspected. Peritoneal scintigraphy with Tc-99m macro-aggregated albumin was performed. Simultaneously, single-photon-emission computed tomography and computed tomography (SPECT/CT) was performed to identify the leakage site using a hybrid system (BrightView XCT; Philips Medical Systems, Cleveland, OH). Radioactive tracer presence in the right hemithorax indicated the existence of PPC, with the right posterior diaphragm suggested as the presumptive leakage site (Figure 2). Nightly automated PD was suspended, and daytime PD was done at low volumes without worsening symptoms until living related renal transplantation was performed.
- Published
- 2015
225. Genetics and clinical features of 15 Asian families with steroid-resistant nephrotic syndrome
- Author
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Akiko Kitamura, Toshio Doi, Jungo Araki, Masataka Honda, Motoshi Hattori, Masaaki Muramatsu, Hitoshi Nakazato, Kandai Nozu, Masahiro Ikeda, Norishige Yoshikawa, Hae Il Cheong, Kazumoto Iijima, Shoji Kagami, Hiroyasu Tsukaguchi, and Yong Choi
- Subjects
Male ,Transplantation ,Asia ,Nephrotic Syndrome ,Adolescent ,business.industry ,Prednisolone ,Drug Resistance ,Intracellular Signaling Peptides and Proteins ,Infant ,Membrane Proteins ,Signs and symptoms ,Glomerulonephritis ,medicine.disease ,Steroid-resistant nephrotic syndrome ,Nephrology ,Child, Preschool ,Immunology ,medicine ,Humans ,Female ,business ,Child ,Nephrotic syndrome - Published
- 2006
226. Outbreak of Salmonella oranienburg infection in Japan
- Author
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Sanpei, Miyakawa, Kazuhiro, Takahashi, Motoshi, Hattori, Katsumi, Itoh, Takanori, Kurazono, and Fumio, Amano
- Subjects
Male ,Japan ,Salmonella ,Child, Preschool ,Decapodiformes ,Animals ,Humans ,Female ,Salmonella Food Poisoning ,Child ,Disease Outbreaks ,Electrophoresis, Gel, Pulsed-Field - Abstract
We experienced five cases of Salmonella oranienburg infection in children living in Saitama prefecture. Thereafter the number of patients with S. oranienburg infection increased not only in Saitama (55 cases) but also in other parts of Japan in 1999 (1505 cases) in 1999. The source of S. oranienburg infection was identified as a snack made from semi-dry cuttlefish.
- Published
- 2006
227. [Sequential combined liver-kidney transplantation for a one-year-old boy with infantile primary hyperoxaluria type 1]
- Author
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Yaeko, Motoyoshil, Motoshi, Hattori, Hiroko, Chikamoto, Hyogo, Nakakura, Takeki, Furue, Sanpei, Miyakawa, Miyuki, Kohno, Katsumi, Ito, Kohtaro, Kai, Ichiro, Nakajima, Shohei, Fuchinoue, Satoshi, Teraoka, Takashi, Akiba, Hirotsugu, Kitayama, Naohiro, Wada, and Yoshihide, Ogawa
- Subjects
Male ,Hyperoxaluria, Primary ,Living Donors ,Humans ,Infant ,Kidney Failure, Chronic ,Kidney Transplantation ,Peritoneal Dialysis ,Liver Transplantation - Abstract
We present the case of a one-year-old male patient with infantile primary hyperoxaluria type 1 (PH1). The patient visited hospital because of growth delay and poor feeding when he was six months old, and was diagnosed as PH1 with chronic renal failure. He underwent peritoneal dialysis until receiving a living-related liver transplantation when he was seventeen months old, and after the operation, underwent hemodialysis or hemodiafiltration four times per week. Six months after the liver transplantation, his serum oxalate level decreased to around 20 micromol/l and a living-related kidney transplantation was successfully performed. Nine months have passed since the kidney transplantation, and the patient's liver and kidney functions have been good and his growth and development much better than before the sequential liver and kidney transplantation. However, his serum and urine oxalate levels remained high and he has required high dose hydration to prevent deposition of calcium oxalate crystals in his grafted kidney. The key-points for treating infantile PHI patients are summarized as follows; 1) make a precise diagnosis as soon as possible, 2) perform a combined liver-kidney transplantation successfully, 3) conduct careful monitoring of the serum and urine oxalate levels and continue adequate hydration after kidney transplantation until the serum and urine oxalate levels normalize. Furthermore, cooperation between the medical staff and the patient's family seems to be essential.
- Published
- 2006
228. Two cases of hyponatremic-hypertensive syndrome in childhood with renovascular hypertension
- Author
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Akira Ashida, Takehisa Yamamoto, Yuki Kiyohara, Hideki Matsumura, Hiroshi Katayama, Hiroshi Tamai, Hyogo Nakakura, Nao Inoue, and Motoshi Hattori
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Renal Artery Obstruction ,Hypokalemia ,Fibromuscular dysplasia ,urologic and male genital diseases ,Nephrectomy ,Renovascular hypertension ,Internal medicine ,medicine.artery ,Angioplasty ,medicine ,Fibromuscular Dysplasia ,Humans ,Renal artery ,Kidney ,Hyperplasia ,business.industry ,Polyuria ,Syndrome ,medicine.disease ,Proteinuria ,medicine.anatomical_structure ,Hypertension, Renovascular ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Cardiology ,Female ,Hyponatremia ,business ,Tunica Intima ,Tunica Media - Abstract
We report two children with renovascular hypertension and fibromuscular dysplasia. They initially presented with severe hyponatremia, hypokalemia, polyuria, and transient proteinuria. This combination of symptoms is known to occur in patients with renovascular and malignant hypertension, and is known as hyponatremic-hypertensive syndrome (HHS), although it is considered rare in children. Since in both of our patients, the renal arterial stenosis was very severely or almost totally occlusive, we could not perform percutaneous transluminal renal artery angioplasty, and therefore nephrectomy was the only option. A histological study showed partial or complete occlusion with intimal hyperplasia and medial fibroplasia of intrarenal arteries such as the interlobular arteries. Conclusion: Both patients showed rapidly progressive renovascular hypertension and loss of function of the affected kidney. In order to preserve renal function in such cases, early invasive intervention appears to be necessary.
- Published
- 2005
229. [Muromonab CD3]
- Author
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Yuko, Akioka, Motoshi, Hattori, and Katsumi, Ito
- Subjects
Graft Rejection ,CD3 Complex ,T-Lymphocytes ,Receptors, Antigen, T-Cell ,Antibodies, Monoclonal ,Pulmonary Edema ,Kidney Transplantation ,Acute Disease ,Cytomegalovirus Infections ,Animals ,Humans ,Infusions, Intravenous ,Immunosuppressive Agents ,Muromonab-CD3 - Published
- 2005
230. Suplatast tosilate dimethylsulfonium treatment for steroid-dependent nephrotic syndrome
- Author
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Shuichiro Fujinaga, Motoshi Hattori, and Yoshiyuki Ohtomo
- Subjects
Adult ,Male ,Adolescent ,business.industry ,Nephrosis, Lipoid ,Prednisolone ,Steroid-dependent nephrotic syndrome ,Sulfonium Compounds ,Pilot Projects ,Th2 cytokines ,Pharmacology ,Steroid responsive ,medicine.disease ,Suplatast tosilate ,Pediatrics, Perinatology and Child Health ,Anti-Allergic Agents ,Anti allergy ,Medicine ,Humans ,Female ,Arylsulfonates ,business ,Child ,Nephrotic syndrome ,Glucocorticoids - Published
- 2005
231. [Renal transplantation and the strategy of treatment for pediatric patients with chronic renal failure]
- Author
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Motoshi, Hattori
- Subjects
Renal Replacement Therapy ,Peritoneal Dialysis, Continuous Ambulatory ,Renal Dialysis ,Child, Preschool ,Humans ,Infant ,Kidney Failure, Chronic ,Hemofiltration ,Child ,Kidney Transplantation - Published
- 2005
232. [Guidelines for handling and assessment of renal biopsy specimens: Brief report from the committee for standardization of renal pathology diagnosis, JSN]
- Author
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Hirofumi, Makino, Hidekazu, Shigematsu, Kensuke, Joh, Takashi, Taguchi, Takao, Saito, Shinichi, Nishi, Seiichi, Matsuo, Hitoshi, Yokoyama, Motoshi, Hattori, Masataka, Honda, and Norishige, Yoshikawa
- Subjects
Biopsy ,Reference Standards ,Kidney ,Medical Records ,Specimen Handling ,Japan ,Nephrology ,Surveys and Questionnaires ,Practice Guidelines as Topic ,Pathology ,Humans ,Kidney Diseases ,Forms and Records Control ,Societies, Medical - Published
- 2005
233. Association between low birth weight and childhood-onset chronic kidney disease in Japan: a combined analysis of a nationwide survey for paediatric chronic kidney disease and the National Vital Statistics Report.
- Author
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Daishi Hirano, Kenji Ishikura, Osamu Uemura, Shuichi Ito, Naohiro Wada, Motoshi Hattori, Yasuo Ohashi, Yuko Hamasaki, Ryojiro Tanaka, Koichi Nakanishi, Tetsuji Kaneko, and Masataka Honda
- Subjects
LOW birth weight ,CHRONIC kidney failure in children ,EPIDEMIOLOGY ,DISEASE incidence - Abstract
Background. Although numerous epidemiological surveys performed across several continents and ethnic groups have linked low birth weight (LBW) to increased risk of chronic kidney disease (CKD) in adulthood, the effects of birth weight and prematurity on development of CKD in childhood have not been clearly established. Methods. Data on sex, LBW incidence and gestational age were compared between paediatric CKD cases and a control group. Paediatric CKD cases were obtained from a nationwide survey conducted by the Pediatric CKD Study Group in Japan. The population attributable fraction was calculated to evaluate the effects of reducing the prevalence of LBW infants (LBWI). Results. Of 447 individuals born between 1993 and 2010 that fulfilled the eligibility criteria, birth weight data were obtained for 381 (85.2%) (231 boys and 150 girls), 106 (27.8%) of whom were LBWI. The proportion of LBWI in the general population during the same period was much lower (8.6%). Therefore, the risk ratio (RR) for paediatric CKD was significantly higher in the LBW group [crude RR: 4.10; 95% confidence interval (CI) 3.62-5.01], and the overall impact on paediatric CKD for removal of LBWamounted to 21.1% (95% CI 16.0-26.1%). In addition, 82 patients (21.9%) with paediatric CKD were born prematurely (before 37 weeks of gestation), and as with LBW, a strong correlation was observed between prematurity and CKD (RR: 4.73; 95% CI 3.91-5.73). Conclusions. Both birth weight and gestational age were strongly associated with childhood-onset CKD in this study. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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234. [Congenital nephrotic syndrome]
- Author
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Motoshi, Hattori
- Subjects
Thyroid Hormones ,Nephrotic Syndrome ,Indomethacin ,Infant ,Membrane Proteins ,Proteins ,Angiotensin-Converting Enzyme Inhibitors ,Genes, Recessive ,Kidney Transplantation ,Nephrectomy ,Proteinuria ,Albumins ,Mutation ,Humans ,Drug Therapy, Combination - Abstract
Although congenital nephrotic syndromes (CNS) form a heterogenous group of disease characterized by proteinuria shortly after birth, the most common type of CNS is the congenital NS of the Finnish type (CNF). CNF is an autosomal recessive disease, and caused by mutations in the gene (NPHS1) for nephrin which is a key component of the podocyte slit diaphragm. In this review, some special issues concerning clinical and molecular diagnosis for CNS and optimal management of CNF patients were briefly summarized.
- Published
- 2004
235. Effect of post-transplant double filtration plasmapheresis on recurrent focal and segmental glomerulosclerosis in renal transplant recipients
- Author
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Nobuo Ishikawa, Katsumi Ito, Hiroshi Nihei, Tadahiko Tokumoto, Kosaku Nitta, Kazunari Tanabe, Motoshi Hattori, Hiroaki Shinmura, Shigeru Otsubo, Hiroshi Toma, and Takashi Akiba
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Urology ,Renal function ,Focal segmental glomerulosclerosis ,Recurrence ,medicine ,Humans ,Postoperative Period ,Segmental glomerulosclerosis ,Child ,Plasma Exchange ,business.industry ,Glomerulosclerosis, Focal Segmental ,Glomerulosclerosis ,Hematology ,Plasmapheresis ,Middle Aged ,medicine.disease ,Double filtration plasmapheresis ,Post transplant ,Surgery ,Transplantation ,surgical procedures, operative ,Nephrology ,Renal transplant ,Disease Progression ,Female ,business ,Filtration ,Immunosuppressive Agents - Abstract
In the present study, we reviewed the effect of post-transplant double filtration plasmapheresis (DFPP) on recurrent focal segmental glomerulosclerosis (FSGS) in the transplanted kidney allograft. Sixteen patients with post-transplant recurrent FSGS were enrolled in this study. Out of 16 patients with recurrent FSGS after transplantation, five did not receive DFPP and lost their grafts, while 11 did receive DFPP and four of these patients lost their grafts. Seven patients were able to maintain normal renal function for an average observation period of 57.1 +/- 40.7 months (range 7-125 months). In five patients who had a significant reduction in urinary protein after DFPP, the urinary protein level decreased from 26.60 +/- 23.05 g/day (range 3.34-62.6 g/day) to 2.95 +/- 3.42 g/day (range 0.02-8.64 g/day) and renal function was maintained. The beneficial effects of DFPP on graft outcome were more likely to occur if the patients experienced a marked drop in urinary excretion. Thus, post-transplant DFPP appears to be effective for reducing urinary protein levels and improving long-term graft survival. With the small numbers in this trial, however, none of the findings were statistically significant. We recommend the use of post-transplant DFPP to prevent the progression of recurrent FSGS.
- Published
- 2004
236. [Management of pediatric chronic renal failure]
- Author
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Motoshi, Hattori and Katsumi, Ito
- Subjects
Chronic Kidney Disease-Mineral and Bone Disorder ,Patient Care Team ,Sclerosis ,Adolescent ,Infant ,Social Support ,Peritoneal Diseases ,Mother-Child Relations ,Japan ,Cardiovascular Diseases ,Renal Dialysis ,Child, Preschool ,Growth Hormone ,Humans ,Kidney Failure, Chronic ,Peritoneum ,Child ,Peritoneal Dialysis ,Growth Disorders - Published
- 2004
237. [Management of pediatric acute renal failure]
- Author
-
Motoshi, Hattori and Katsumi, Ito
- Subjects
Patient Care Team ,Adolescent ,Multiple Organ Failure ,Infant, Newborn ,Hemodiafiltration ,Acute Kidney Injury ,Prognosis ,Diagnosis, Differential ,Renal Dialysis ,Child, Preschool ,Humans ,Hemofiltration ,Child ,Peritoneal Dialysis - Published
- 2004
238. A combined low-density lipoprotein apheresis and prednisone therapy for steroid-resistant primary focal segmental glomerulosclerosis in children
- Author
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Akira Matsunaga, Hyogo Nakakura, Yuko Akioka, Miyuki Khono, Motoshi Hattori, Daisuke Ogino, Hiroshi Kawaguchi, Katsumi Ito, Hiroko Chikamoto, Sanpei Miyakawa, and Akira Fukazawa
- Subjects
Nephrology ,Male ,medicine.medical_specialty ,Nephrotic Syndrome ,Adolescent ,medicine.drug_class ,Urology ,Drug Resistance ,Hyperlipidemias ,urologic and male genital diseases ,Prednisone ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Cellulose ,Child ,Primary Focal Segmental Glomerulosclerosis ,business.industry ,Glomerulosclerosis, Focal Segmental ,Dextran Sulfate ,Remission Induction ,Glomerulosclerosis ,medicine.disease ,Combined Modality Therapy ,Lipoproteins, LDL ,Proteinuria ,Endocrinology ,Treatment Outcome ,Blood Component Removal ,Cyclosporine ,Corticosteroid ,Female ,business ,Nephrotic syndrome ,medicine.drug ,Kidney disease ,Follow-Up Studies - Abstract
Background: Treatment of steroid-resistant (SR) primary focal segmental glomerulosclerosis (FSGS) remains a major challenge in nephrology. A prospective study was conducted to clarify the therapeutic role of low-density lipoprotein apheresis (LDL-A) in 11 nephrotic children with SR and cyclosporine A (CsA)-resistant primary FSGS. Methods: Based on entry criteria, all 11 eligible patients had biopsy-proven primary FSGS presenting with nephrotic syndrome (NS) and were resistant to steroid and conventional-dose CsA therapy. LDL-A was performed twice a week for 3 weeks (first course), then weekly for 6 weeks (second course). Beginning from the second LDL-A course, a dosage of 1 mg/kg/d of prednisone was administered for 6 weeks, then tapered. Results: Seven patients experienced remission of NS, 5 of whom achieved complete remission within 4 weeks after initiating prednisone therapy with LDL-A. These 5 patients maintained normal renal function during follow-up (median, 4.4 years). Of 2 patients with partial remission, 1 patient maintained stable renal function during follow-up (4.5 years), whereas the other patient showed a gradual decline in renal function and progressed to end-stage renal failure (ESRF) 7.8 years after LDL-A therapy. Four patients who were considered to experience treatment failure had persistent NS and progressed to ESRF in 1.3 years (median) after LDL-A therapy. Complete remission (n = 5) was associated with significantly more highly selective proteinuria compared with treatment failure (n = 4). Conclusion: This study suggests that combined LDL-A and prednisone therapy can be a valuable addition to therapeutic options for treating patients with SR-FSGS. The role of LDL-A in treating these patients deserves to be assessed further in larger randomized controlled trials.
- Published
- 2003
239. [Therapy for children with Shiga toxin-E. coli-associated hemolytic uremic syndrome]
- Author
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Katsumi, Ito, Motoshi, Hattori, and Naoko, Matsumoto
- Subjects
Adult ,Plasma Exchange ,Hemolytic-Uremic Syndrome ,Humans ,Child ,Escherichia coli O157 ,Escherichia coli Infections ,Gastroenteritis ,Shiga Toxin - Abstract
Hemolytic uremic syndrome(HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute nephropathy. Clinical features and outcome of children with HUS initiated by infections with Shiga toxin(Stx)-producing strains of Escherichia coli(E. coli) infection are different from those of patients with the other forms of HUS or thrombotic thrombocytopenic purpura(TTP). Childhood Stx-E. coli-associated HUS usually recovers spontaneously and dose not require specific treatments including plasma therapy. In contrast, a general consensus has been achieved that plasma exchange or infusion should always be tried in adult HUS/TTP to minimize the risk of death or long-term sequelae. In this paper, we briefly reviewed therapy for patients with Stx-E. coli-associated HUS.
- Published
- 2002
240. A case of post-transplant hyperparathyroidism treated with ethanol injection
- Author
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Katsumi Ito, Hirotaka Kihara, Yoshihisa Kinoshita, Tetsuro Tsuji, Hiroyuki Nagafuchi, Toshiyuki Ohta, Takashi Sakano, Kazunari Tanabe, Motoshi Hattori, Shohei Fuchinoue, and Hiroshi Shiraga
- Subjects
Parathyroidectomy ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Urology ,Tertiary hyperparathyroidism ,Administration, Cutaneous ,Injections ,Parathyroid Glands ,medicine ,Humans ,Hyperparathyroidism ,Ethanol ,business.industry ,medicine.disease ,Kidney Transplantation ,Surgery ,Transplantation ,medicine.anatomical_structure ,Methylprednisolone ,Nephrology ,Pediatrics, Perinatology and Child Health ,Parathyroid gland ,Percutaneous ethanol injection ,business ,Hypophosphatemia ,medicine.drug - Abstract
A 15-year-old boy with chronic renal failure secondary to Alport's syndrome underwent living-related renal transplantation from his 48-year-old father. His primary immunosuppressive regimen was composed of tacrolimus, mizolibine, and methylprednisolone. The postoperative course was satisfactory with one episode of mild acute rejection, treated successfully with methylprednisolone pulse therapy. Two months later, hypercalcemia (11.8-13.2 mg/dl) and hypophosphatemia (2.5-3.0 mg/dl) were noted without any bone symptoms. The serum intact-parathyroid hormone (PTH) and serum alkaline phosphatase levels were 240 pg/ml and 2483 IU/l, respectively. Ultrasound studies revealed enlargement of the two parathyroid glands. Under the diagnosis of tertiary hyperparathyroidism, he underwent percutaneous ethanol injection (PEIT) into the left parathyroid gland. Although levels of serum calcium and phosphorus returned to normal ranges and the intact PTH level decreased to 95 pg/ml with the three injections, another injection was needed to normalize recurrent hypercalcemia 2 months later. The patient experienced only transient mild dysphonia and local pain after PEIT. Although PEIT is believed less effective than parathyroidectomy, it has some advantages such as applicability to high-risk patients, repeatability of treatment, low incidence and severity of side effects.
- Published
- 2002
241. Antineutrophil cytoplasmic autoantibody-associated glomerulonephritis in children
- Author
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Yasushi Koitabashi, Hideaki Kurayama, and Motoshi Hattori
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Adolescent ,Renal function ,Kidney ,Gastroenterology ,Antibodies, Antineutrophil Cytoplasmic ,chemistry.chemical_compound ,Glomerulonephritis ,Recurrence ,Internal medicine ,medicine ,Humans ,Life Tables ,Child ,Anti-neutrophil cytoplasmic antibody ,Creatinine ,business.industry ,Autoantibody ,General Medicine ,medicine.disease ,Prognosis ,medicine.anatomical_structure ,chemistry ,Nephrology ,Child, Preschool ,Female ,Microscopic polyangiitis ,business ,Kidney disease - Abstract
Aretrospective investigation was conducted by members of the Japanese Society for Pediatric Nephrology from 1990 to 1997 to define the clinical features and outcome of antineutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis in children. Thirty-four ANCA-seropositive Japanese pediatric patients with biopsy-proven pauci-immune necrotizing crescentic glomerulonephritis were identified. Of these, 3 cases associated with Wegener's granulomatosis were excluded because of the small sample size. Among the 31 patients studied, 10 had a diagnosis of necrotizing crescentic glomerulonephritis alone and 21 had microscopic polyangiitis. Females predominated (87%), and the median age at onset was 12 yr. Twenty-six patients received treatment with cyclophosphamide and corticosteroids, and five patients received treatment with corticosteroids alone; 84% of patients achieved remission, and 39% of responders relapsed in a median of 24 mo. ANCA titers correlated with response to treatment and disease activity, with some exceptions. Patients were followed for a median of 42 mo (range, 3 to 96 mo). Nine of 31 patients (29.0%) progressed to end-stage renal disease, 6 (19.4%) had reduced renal function, and 15 (48.4%) had normal renal function at the last observation. One patient (3.2%) died from cytomegalovirus infection 3 mo after initiation of therapy. Life-table analysis showed 75% renal survival at 39 mo. Patients who subsequently developed end-stage renal disease (n = 9) had significantly higher average peak serum creatinine levels and more chronic pathologic lesions at diagnosis compared with patients with favorable renal outcome (n = 15). In conclusion, our clinical experience suggests that the clinical disease spectrum of ANCA-associated glomerulonephritis is similar in pediatric and adult patients, but there is a female predominance in children.
- Published
- 2001
242. Phenotypic characteristics and cyclin-dependent kinase inhibitors repression in hyperplastic epithelial pathology in idiopathic focal segmental glomerulosclerosis
- Author
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Katsumi Ito, Teruo Watanabe, Yujing Shu, Sawako Shibata, Motoshi Hattori, Shigeru Horita, and Michio Nagata
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Adolescent ,Cyclin A ,Cell Cycle Proteins ,Kidney ,Focal Glomerulonephritis ,Pathology and Forensic Medicine ,Podocyte ,Cytokeratin ,medicine ,Humans ,Enzyme Inhibitors ,Child ,Molecular Biology ,Psychological repression ,Cyclin-Dependent Kinase Inhibitor p57 ,Cyclin ,Hyperplasia ,biology ,Kinase ,Glomerulosclerosis, Focal Segmental ,Tumor Suppressor Proteins ,Microfilament Proteins ,Nuclear Proteins ,Cell Biology ,Cell cycle ,Immunohistochemistry ,Cyclin-Dependent Kinases ,medicine.anatomical_structure ,Ki-67 Antigen ,biology.protein ,Female ,Urothelium ,Microtubule-Associated Proteins ,Cyclin-Dependent Kinase Inhibitor p27 - Abstract
Hyperplastic glomerular epithelial lesion is an important determinant of the progression of idiopathic focal segmental glomerulosclerosis (FGS). The proliferation and differentiation of glomerular epithelial cells and parietal epithelial cells (PECs) are regulated differently by cyclin and cyclin-dependent kinase inhibitors (CKIs) during nephrogenesis. To access the cellular mechanism underlying epithelial hyperplasia in the development of FGS, the present study applied immunohistochemistry to 21 cases of FGS to demonstrate expression of cell-cycle molecules and phenotypic characterization in proliferative epithelial lesions in FGS. The materials included segmental sclerosis (18.1%), which was divided into monolayer epithelial lesions (64.6%) and cellular lesions (35.4%). All of the cellular lesions expressed cytokeratin, frequently with Ki-67 (82.4%) and less frequently with cyclin A (17.7%), but were invariably negative for podocyte markers (PHM-5 and synaptopodin) and CKIs (p27kip1 and p57kip2). Podocytes in nonsclerotic tuft in the same glomeruli with cellular lesions strongly expressed CKIs and podocyte markers. Moreover, electron microscopy showed that some large proliferating cells with prominent nucleoli have a broad cell base attached to Bowman's capsule. These cells have cilia and a junctional complex with neighboring hyperplastic cells, some of which directly cover the glomerular basement membrane. This suggests that cellular lesions are of PEC origin. Monolayer epithelial lesions also exclusively exhibited a PEC phenotype with reciprocal expression of podocyte markers and cytokeratin. In addition, CKIs are weakly expressed in monolayer epithelial lesions, suggesting a re-entry of cell-cycle quiescent. In conclusion, proliferation of PEC, sustained by repression of CKIs in nature and simultaneous activation of cyclin A, is the actual molecular background to the cellular lesions in FGS. Cellular lesions may result in monolayer epithelial lesions that retain the PEC phenotype and enter a common pathway to glomerulosclerosis.
- Published
- 2000
243. THE PATHOLOGICAL SIGNIFICANCE OF MEDULLARY RAY INJURY (MRI) IN RENAL ALLOGRAFTS
- Author
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Satoshi Teraoka, Yutaka Yamaguchi, Y Kanetsuna, Motoshi Hattori, Akimitsu Kobayashi, Kenneth K. Tanabe, Shuichi Ito, Izumi Yamamoto, and Yuko Akioka
- Subjects
Transplantation ,Pathology ,medicine.medical_specialty ,Medullary ray (anatomy) ,business.industry ,Medicine ,business ,Pathological - Published
- 2008
244. Mesangial phenotypic changes associated with cellular lesions in primary focal segmental glomerulosclerosis
- Author
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Yutaka Yamaguchi, Hiroshi Kawaguchi, Shigeru Horita, Toshimasa Yoshioka, Motoshi Hattori, and Katsumi Ito
- Subjects
Pathology ,medicine.medical_specialty ,Biopsy ,Antigens, Differentiation, Myelomonocytic ,Muscle Proteins ,urologic and male genital diseases ,Statistics, Nonparametric ,Lesion ,Antigens, CD ,Medicine ,Humans ,Endocapillary hypercellularity ,Child ,Kidney ,Analysis of Variance ,Histocytological Preparation Techniques ,Mesangial cell ,urogenital system ,business.industry ,Primary Focal Segmental Glomerulosclerosis ,Glomerulosclerosis, Focal Segmental ,Nephrosis, Lipoid ,Glomerulosclerosis ,medicine.disease ,Immunohistochemistry ,female genital diseases and pregnancy complications ,Actins ,Glomerular Mesangium ,medicine.anatomical_structure ,Phenotype ,Nephrology ,Child, Preschool ,Collagen ,medicine.symptom ,business ,Nephrotic syndrome ,Myofibroblast - Abstract
Injury to glomerular visceral epithelial cells has been proposed as the initial step in glomerular scar formation in primary focal segmental glomerulosclerosis (FSGS); however, the subsequent process that ultimately results in glomerular scar formation remains uncertain. This study examined whether phenotypically altered mesangial cells determine the early progression of primary FSGS. Cellular lesion characterized by proliferative epithelial cell reaction with occasional endocapillary hypercellularity has been considered to be an early morphologic feature in the development of glomerular scar in primary FSGS. We compared the immunohistologic findings of 10 patients with primary FSGS showing cellular lesion, 15 patients with primary FSGS showing only segmental scar, and 10 patients with minimal-change nephrotic syndrome. Histologically normal kidney tissue samples obtained from three patients with renal trauma were used as normal controls. Alpha-smooth muscle actin expression detected by a mouse anti-human monoclonal antibody as well as de novo type III collagen expression determined by a goat polyclonal antibody were prominent in the glomerular tufts with cellular lesions in FSGS patients. A significant increase in the number of glomerular CD68+ (a mouse anti-human monoclonal antibody) macrophages was also observed in association with the cellular lesion. Repeat renal biopsies in six of the 10 FSGS patients with a cellular lesion showed disappearance of the cellular lesion, reduced glomerular alpha-smooth muscle actin expression, decreased number of glomerular CD68+ macrophage, and progression of glomerular scar formation. These results indicate that mesangial cells undergo phenotypic changes to myofibroblasts in association with the cellular lesion in primary FSGS. Thus, the phenotypically altered mesangial cells acquiring features of a myofibroblast may have an important role in the early process of glomerular scar formation in certain types of primary FSGS.
- Published
- 1997
245. Questions regarding abo-incompatible kidney transplantation in children
- Author
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Hiroshi Shiraga, Katsumi Ito, Kazunari Tanabe, Toshiyuki Ohta, Motoshi Hattori, and Hiroshi Kawaguchi
- Subjects
Nephrology ,Transplantation ,medicine.medical_specialty ,Pediatrics ,business.industry ,ABO blood group system ,Internal medicine ,medicine ,business ,medicine.disease ,Kidney transplantation - Published
- 2002
246. Age-Dependent Phosphate Homeostasis Is Regulated by a Circulating Factor
- Author
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Katsumi Ito, Yasuhiro Komatsu, Naoko Matsumoto, Hiroshi Shiraga, and Motoshi Hattori
- Subjects
Adult ,Aging ,medicine.medical_specialty ,Adolescent ,Renal function ,Phosphate homeostasis ,Phosphates ,chemistry.chemical_compound ,Internal medicine ,Pi ,medicine ,Homeostasis ,Humans ,Child ,Kidney ,business.industry ,Age Factors ,Blood Proteins ,Metabolism ,Phosphate ,medicine.disease ,Kidney Transplantation ,Transplantation ,Endocrinology ,medicine.anatomical_structure ,chemistry ,Child, Preschool ,business ,Kidney disease - Abstract
To evaluate the age-dependent phosphate homeostasis, we studied the serum inorganic phosphate (Pi) concentration in 78 recipients, aged 5–25 years, a year after renal transplantation (RT). The significant age-dependent decline of the serum Pi concentration was observed in recipients (p < 0.0001) as well as in normal children. Our study revealed that a circulating factor may play a central role in the age-dependent change of phosphate regulation in human.
- Published
- 2002
247. Partial kidney transplantation: a successful kidney transplantation in a child with severe cardiac failure by surgical mass reduction of an adult donor kidney
- Author
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Kota Takahashi, Hiroshi Kawaguchi, Motoshi Hattori, Katsumi Ito, Makoto Nakazawa, Kazuo Ota, Tetsuzo Agishi, Takashi Yagisawa, Hayakazu Nakazawa, Kazunari Tanabe, and Hiroshi Toma
- Subjects
Nephrology ,Cardiac function curve ,Adult ,medicine.medical_specialty ,Cardiac output ,Cardiomyopathy ,Cardiac Output, Low ,Mitral valve stenosis ,Internal medicine ,Medicine ,Humans ,Mitral Valve Stenosis ,Child ,Kidney transplantation ,Kidney ,Transplantation ,business.industry ,Body Weight ,Organ Size ,medicine.disease ,Kidney Transplantation ,Tissue Donors ,Surgery ,medicine.anatomical_structure ,Kidney Failure, Chronic ,Female ,business - Abstract
We report on a trial of partial kidney transplantation performed on a low body weight child with impaired cardiac function due to mitral valve stenosis and uremic cardiomyopathy. The weight of the donated kidney was successfully reduced by one-third using bench surgery in order to obtain sufficient graft perfusion and function. Our procedure is justified when a graft is too large to be adequately perfused in a recipient suffering from cardiac failure.
- Published
- 1993
248. Treatment with a combination of low-density lipoprotein aphaeresis and pravastatin of a patient with drug-resistant nephrotic syndrome due to focal segmental glomerulosclerosis
- Author
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Toshihisa Tanaka, Miyuki Khono, Hiroshi Kawaguchi, Katsumi Ito, Reiko Kubota, and Motoshi Hattori
- Subjects
Nephrology ,Male ,medicine.medical_specialty ,Nephrotic Syndrome ,Adolescent ,Urology ,Drug Resistance ,Renal function ,Hyperlipidemias ,Kidney Function Tests ,Focal segmental glomerulosclerosis ,Internal medicine ,medicine ,Humans ,Pravastatin ,Proteinuria ,business.industry ,Glomerulosclerosis, Focal Segmental ,Glomerulosclerosis ,Glomerulonephritis ,medicine.disease ,Combined Modality Therapy ,Surgery ,Lipoproteins, LDL ,Pediatrics, Perinatology and Child Health ,Blood Component Removal ,lipids (amino acids, peptides, and proteins) ,medicine.symptom ,business ,Nephrotic syndrome ,Immunosuppressive Agents ,medicine.drug - Abstract
Results of recent animal studies have lent support to the hypothesis that hyperlipidaemia may contribute to renal injury. This report documents the case of a 15-year-old boy with drug-resistant nephrotic syndrome due to focal segmental glomerulosclerosis (FGS) who showed an improvement in renal function and proteinuria as a result of treatment with low-density lipoprotein aphaeresis (LDL-A) combined with pravastatin. Although further work is required to determine the efficacy of lipid-lowering therapy in progressive glomerular disease in humans, the combination of LDL-A and pravastatin is likely be included in the choice of treatment modalities available for patients with drug-resistant nephrotic syndrome due to FGS.
- Published
- 1993
249. Characteristic glomerular lesions in the ExHC rat: a unique model for lipid-induced glomerular injury
- Author
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Katsumi Ito, Yutaka Yamaguchi, Hiroshi Kawaguchi, and Motoshi Hattori
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Time Factors ,Kidney Glomerulus ,urologic and male genital diseases ,Pathogenesis ,Cholesterol, Dietary ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,Internal medicine ,medicine.artery ,medicine ,Animals ,Pathological ,Histological examination ,Aorta ,Proteinuria ,business.industry ,Cholesterol ,Glomerulosclerosis ,Glomerulonephritis ,medicine.disease ,Lipid Metabolism ,Lipids ,Rats ,Disease Models, Animal ,Microscopy, Electron ,Endocrinology ,chemistry ,medicine.symptom ,business ,Foam Cells - Abstract
ExHC rats were bred from the Sprague-Dawley strain and are highly susceptible to dietary hypercholesterolemic stimuli. Although chemical and histological examination of the aorta from ExHC rats fed a diet containing 3% cholesterol, 0.6% sodium cholate and 15% olive oil (high-cholesterol diet, HCD) has been reported, renal injury in this model has not been investigated to date. Therefore, we examined the renal pathological changes and proteinuria in this model. ExHC rats fed an HCD developed proteinuria and characteristic glomerular lesions within 4-8 weeks after initiation of the diet. The most striking glomerular change observed in this model was the marked accumulation of numerous lipid-filled foam cells, with a surface marker that identified them as macrophages, within the mesangial regions which could have been involved in focal and segmental glomerular sclerosis. Our study demonstrates that ExHC rats fed a cholesterol-supplemented diet develop glomerular injury that may be mediated by infiltrating macrophages. These results imply that ExHC rats may be well-suited for the use in investigations of the role of macrophages in the pathogenesis of lipid-induced glomerular injury.
- Published
- 1993
250. The essence of treatment for CKD patients
- Author
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Sadayoshi Ito, Toshiyuki Nakao, Motoshi Hattori, Yasuhiro Ando, Tetsuo Kato, Masaru Horio, Osamu Uemura, Masafumi Fukagawa, Genjiro Kimura, and Tetsuya Mitarai
- Subjects
Clinical Practice ,Nephrology ,medicine.medical_specialty ,Physiology ,business.industry ,Physiology (medical) ,Internal medicine ,medicine ,Alternative medicine ,MEDLINE ,Intensive care medicine ,business - Published
- 2009
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