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16. 外来維持透析患者における栄養指導は、透析間体重増加と血圧を調整する

Author

Sakai, Atsuko, Hamada, Hisayo, Hara, Keiko, Mori, Kyoko, Uchida, Takayuki, Mizuguchi, Takashi, Minaguchi, Jun, Shima, Kenji, Kawashima, Shu, Hamada, Yasuhiro, and Nikawa, Takeshi

Subjects
hemodialysis, hypertension, nutritional counseling, salt and water restriction, interdialytic weight gain
Abstract

Maintenance hemodialysis outpatients must limit salt and water intake to maintain electrolyte balance and blood pressure. In Kawashima Hospital, nationally registered dietitians provide hemodialysis patients with monthly nutritional counseling. We investigated whether nutritional counseling affects interdialytic weight gain (IDWG) and blood pressure. We investigated 48 hemodialysis patients whose monthly average IDWG ratio to dry weight exceeded 5.1% and who had not had a long-term hospital admittance of ＞1 month. After the 48-month nutritional counseling period, the IDWG ratio had improved in 37 of the patients (77.1%), significantly decreasing from 6.0±0.7 to 5.3±0.9%. Estimated salt and water intake decreased significantly from 13.3±2.7 to 11.8±2.4 g/day and 2528±455 to 2332±410 ml/day, respectively. During the intervention period, normalized protein catabolic rate and body mass index did not change substantially. Pre-hemodialysis systolic and diastolic blood pressures had significantly decreased from 149±19 to 134±18 mmHg, and 82±13 to 75±10 mmHg for 48 months after study initiation, respectively. The dosage of antihypertensive drugs had significantly decreased in the group that experienced improvement in the IDWG ratio. Long-term nutritional counseling by nationally registered dietitians may improve the IDWG ratio and blood pressure of hemodialysis patients by decreasing their salt and water intake.

Published
2017

17. Circulating FGF23 is not associated with cardiac dysfunction, atherosclerosis, infection or inflammation in hemodialysis patients

Author

Takashi, Yuichi, primary, Wakino, Shu, additional, Minakuchi, Hitoshi, additional, Ishizu, Masashi, additional, Kuroda, Akio, additional, Shima, Hisato, additional, Tashiro, Manabu, additional, Miya, Keiko, additional, Okada, Kazuyoshi, additional, Minakuchi, Jun, additional, Kawashima, Shu, additional, Matsuhisa, Munehide, additional, Matsumoto, Toshio, additional, and Fukumoto, Seiji, additional

Published
2019
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24. Association between periodontal condition and kidney dysfunction in Japanese adults : A cross‐sectional study

Author

Naruishi, Koji, Oishi, Keiji, Inagaki, Yuji, Horibe, Masumi, Bando, Mika, Ninomiya, Masami, Kawahara, Kazuhiko, Minakuchi, Jun, Kawashima, Shu, Shima, Kenji, Kido, Jun-ichi, Nagata, Toshihiko, Naruishi, Koji, Oishi, Keiji, Inagaki, Yuji, Horibe, Masumi, Bando, Mika, Ninomiya, Masami, Kawahara, Kazuhiko, Minakuchi, Jun, Kawashima, Shu, Shima, Kenji, Kido, Jun-ichi, and Nagata, Toshihiko

Abstract

Recent studies have demonstrated that chronic kidney disease (CKD) may be associated with the progression of periodontal disease. Diabetes mellitus (DM) is a major risk factor for CKD. The objective of this study was to clarify the relationship between periodontal condition and kidney dysfunction in patients who had kidney failure with or without DM. One hundred sixty‐four patients with kidney dysfunction were enrolled (male: N = 105; female: N = 59), and the relationship between periodontal condition and kidney dysfunction was analyzed in a cross‐sectional study. The subjects were divided into three groups: (a) patients with DM, (b) dialysis patients with nephropathy due to various kidney diseases, and (c) dialysis patient with nephropathy due to DM (diabetic nephropathy). Then, the effect of DM on the periodontal condition was analyzed. The patients were also stratified by CKD stage (into G1–G5) using the estimated glomerular filtration rate (eGFR), and the G5 group was divided in patients with or without DM. Correlations between eGFR and parameters of periodontal condition were calculated in patients from G1 to G4. The number of missing teeth was significantly higher in dialysis patients with diabetic nephropathy than in patients with DM, whereas alveolar bone loss did not show a significant difference among the three groups. In addition, the G5 patients with DM had a significantly higher number of missing teeth than the other CKD groups, whereas alveolar bone loss did not show a significant difference. In G5 patients with DM, Community Periodontal Index and Oral Hygiene Index scores were significantly higher than in G1‐4 patients with DM. There was a significant negative correlation between eGFR and the number of missing teeth. Patients with diabetic nephropathy have a higher rate of periodontal problems such as missing teeth in Japanese adults.

Published
2016

25. Association between periodontal condition and kidney dysfunction in Japanese adults: A cross‐sectional study

Author

Naruishi, Koji, primary, Oishi, Keiji, additional, Inagaki, Yuji, additional, Horibe, Masumi, additional, Bando, Mika, additional, Ninomiya, Masami, additional, Kawahara, Kazuhiko, additional, Minakuchi, Jun, additional, Kawashima, Shu, additional, Shima, Kenji, additional, Kido, Jun‐ichi, additional, and Nagata, Toshihiko, additional

Published
2016
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27. Aldosterone and Insulin Resistance: Vicious Combination in Patients on Maintenance Hemodialysis.

Author

Wakino, Shu, Minakuchi, Hitoshi, Miya, Keiko, Takamatsu, Norimichi, Tada, Hiroaki, Tani, Erina, Inamoto, Hajime, Minakuchi, Jun, Kawashima, Shu, and Itoh, Hiroshi

Abstract

Abstract: Recently, we demonstrated that plasma aldosterone contributed to insulin resistance in chronic kidney disease. The aim of this study is the clinical impact of this relationship in hemodialysis patients. In a cross section study using a total of 128 hemodialysis patients, multiple regression analysis revealed that plasma aldosterone levels were independently associated with HOMA‐IR, insulin resistance index. This association was found to be more stringent in diabetic patients than in non‐diabetic patients. Aldosterone levels were associated with cardiac hypertrophy and carotid artery stenosis. HOMA‐IR was associated with cardiac hypertrophy. The patients whose aldosterone and HOMA‐IR were above the top tertile of each parameter in this cohort showed more severe cardiac hypertrophy and lower contractile function as compared with the patients whose aldosterone levels and HOMA‐IR are below the lowest tertile of each parameter. In conclusion, in hemodialysis patients, aldosterone levels and insulin resistance are closely interrelated and the constellation of the two is related to severe cardiovascular tissue damages. [ABSTRACT FROM AUTHOR]

Published
2018
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33. Present status of Japanese ethics committees : a survey in Tokushima Prefecture

Author

Katashima, Rumi, Sato, Chiho, Kinoshita, Seizo, Kawashima, Shu, Yanagawa, Hiroaki, Katashima, Rumi, Sato, Chiho, Kinoshita, Seizo, Kawashima, Shu, and Yanagawa, Hiroaki

Abstract

Clinical research is important to improve medical quality, and ethics review is essential to conduct clinical research. Since the establishment of the first Japanese ethics committee at the University of Tokushima in 1982, Japanese ethics committees have increased. In this study, we surveyed the status of clinical studies and ethics committees in one Japanese region. The survey was conducted in collaboration with the Tokushima Medical Association. A questionnaire was established and mailed to all medical institutions (n=737) registered to the Tokushima Medical Association in 2012. Among 737, 223 (30.3%) questionnaires were returned and 221 were completed and are included in this analysis (respondents). Among respondents, 51 (23.1%) had performed clinical research, and of these, 17 had established ethics committees (though one was omitted from the following analysis due to an unsatisfactory response). Among 16 ethics committees, review of protocol amendments, review of serious adverse events, annual follow-up of approved protocols, and education for committee members were active in 10 (62.5%), 9 (56.3%), 6 (37.5%) and 4 (25.0%), respectively. Research ethics education was active in 4 (25.0%). Based on the results, we attempt to establish an appropriate system for ethical conduct of health-related research in Tokushima Prefecture.

Published
2014

43. Maintenance hamatocrit levels and mortality in hemodialysis patients with renal anemia receiving recombinant human erythropoietin(rHuEPO) treatment(rHuEPO survey).

Author

Hirasawa, Yoshihei, primary, Suzuki, Masashi, additional, Itami, Noritomo, additional, Ohira, Seiji, additional, Mizuno, Tsuguo, additional, Mera, Kentaro, additional, Haga, Yoshiharu, additional, Kawai, Hironobu, additional, Mashimo, Keiichi, additional, Obara, Isahiro, additional, Kurosawa, Norio, additional, Nakamoto, Yasushi, additional, Numazawa, Kazuo, additional, Furuhashi, Mitsuyoshi, additional, Maruyama, Yukitaka, additional, Miki, Ryuji, additional, Koike, Shigefumi, additional, Seno, Hachiro, additional, Kawahara, Hirohisa, additional, Kobayashi, Hiroyuki, additional, Ono, Toshihiko, additional, Okuno, Senji, additional, Kim, Masao, additional, Miyazaki, Ryoichi, additional, Saika, Yasushi, additional, Motomiya, Yoshihiro, additional, Taniai, Kazuhi, additional, Usui, Koji, additional, Shigemoto, Kenichiro, additional, Mizuguchi, Takashi, additional, Kawashima, Shu, additional, Yuasa, Kenji, additional, Ohta, Kazumichi, additional, Sato, Takashi, additional, Fukunari, Kenichi, additional, Kimura, Yuzo, additional, Takahashi, Hisashi, additional, and Yuu, Kougi, additional

Published
2003
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48. 野生動物に関する大学入学前の経験変化と進路選択

Author

Motokazu, Ando, Kamito Takehiko, and Kawashima Shu

Subjects
進路, 学生, 入学前, 野生動物, 動物教育, wildlife, animal education, pre-university age, job opportunity, student experience
Abstract

学生が大学入学前にどのような野生動物関連の知識と体験を有しているか,東京農大生を対象に2002年と2012年にアンケート調査した。野外で見たことのある動物は2002年には鳥類>哺乳類>魚類>爬虫類>両生類の順であったが,2012年には爬虫類,両生類,魚類が大きく減少した。後者は水辺などに行かねば見られない動物であることから,この10年間に若年層の自然に触れる機会が減少していると思われた。野生動物に関する知識や意識における10年間の変化は少なかった。野生動物の目撃場所では,自宅周辺や里山が多く,旅行中の目撃頻度は減少傾向にあった。学生がイメージできる野生動物関連職業の数は少なく,動物園や研究職など一部職種に集中していた。好きな日本産動物の上位は陸生の中・大型哺乳類で占められ,食虫目や翼手目への関心は極めて低かった。好きな世界の動物では動物園で見ることのできるライオン,パンダ,ゾウ,コアラ,トラなどの大型獣が上位であった。野生動物に関する情報源としては特定のテレビ番組が大きな役割を果たしており,本では動物図鑑がよく利用されていた。動物系学科で学ぶ学生(東京農業大学)と非動物系の学生(国際基督教大学)を比較すると,野生動物教育の経験を除いて,アンケート結果は類似しており,入学前における野生動物経験の多寡は大学選択に影響していなかった。動物系の異なる研究室(野生動物学と動物介在療法)に所属する学生の野生動物経験を比較したところ,回答傾向は概ね類似したが,後者では鳥類や獣害に対する関心が若干低かった。, Wildlife-related knowledge and experiences of freshman students during their pre-university ages were surveyed by questionnaire. Field encounter frequencies with animals in 2002 were in the order of birds>mammals>fish>reptiles>amphibians. In 2012 there were decreases in the frequency and species number of reptiles, amphibians and in particular fish, indicating that the younger generation was moving further away from nature. The most common mammals encountered in the field were raccoon dog, followed by fox, deer and monkey. Encounters mainly took place at Satoyama environments, while those during trips decreased. Big zoo mammals such as lion, panda and elephant were popular. TV programs were main sources of wildlife information. In particular some selected animal and nature programs had a strong influence. Animal encyclopedias played an important role as sources of wildlife information. The average number of wildlife-related jobs that students can conceive of was limited to 4.4, and their main focus was zoo keepers and researchers. Supply of job information as well as vocational education is needed. Comparing students of humanities course (International Christian University) and the animal science course (Tokyo University of Agriculture), their wildlife-related knowledge and experience during pre-university age were similar, except that the latter had stronger interests in zoos. Comparing students of different laboratories (wildlife and animal-facilitated-therapy), influence of laboratory research topics on their wildlife-consciousness was limited.

49. 初心者の乗馬における精神的・生理的変化に関する研究

Author

Maho, Fuchikami, Kawashima Shu, and Uchiyama Hidehiko

Subjects
Horse (Equine) assisted activity, horse riding, mental effects, questionnaire survey, Heart rate variability, 馬を用いた動物介在活動,乗馬,精神的効果,アンケート調査,心拍変動解析
Abstract

馬を用いた動物介在活動や療法の研究領域において,馬がもたらす精神的効果に関する報告は,信頼性やその数値化の困難さから多くは見られない。馬と関わる活動に参加することが初めてである多くの対象者において,乗馬に対し慣れや親しみを抱くまでの期間,またそれら精神的変化と乗馬との関係性について明らかにし,初心者が安心し継続的な参加を促すことができる活動内容の構築が馬を用いた介在療法・活動において重要であると考えられる。そこで本研究では,乗馬初心者を対象とし,乗馬に対する精神的,生理的変化を明らかにすることを目的とし,乗馬に対する興味・関心や不安・恐怖等の感情に関するアンケート調査および心拍変動測定による自律神経変動の解析を行った。得られたデータから,初心者が乗馬を重ねるごとの精神的・生理的変化について検証した結果,アンケートでは乗馬に対する不安や緊張といった否定的な感情に関連する項目は回数を重ねるごとに減少し,3回目,4回目において1回目と比較して有意な減少が見られた(P, There are few scientific papers reporting the effects of Equine Assisted Activity (EAA), and, reliable statistical approaches have not been well established so far. The present study is conducted to clarify both mental and physiological changes in beginners of EAA. The mental effect was surveyed by questionnaire filled out by beginners before and after horseback riding, and the physiological effect was analyzed by Heart rate variability (HRV) for measuring changes in the autonomic nervous system. The results of the questionnaire survey indicate that the negative emotions of fear or anxiety about the horse itself and horseback riding during the third and fourth time riding session were significantly reduced (P

50. Nutritional counseling regulates interdialytic weight gain and blood pressure in outpatients receiving maintenance hemodialysis.

Author

Sakai A, Hamada H, Hara K, Mori K, Uchida T, Mizuguchi T, Minaguchi J, Shima K, Kawashima S, Hamada Y, and Nikawa T

Subjects
Adult, Ambulatory Care, Antihypertensive Agents administration & dosage, Blood Pressure, Female, Humans, Hypertension etiology, Hypertension prevention & control, Male, Middle Aged, Nutrition Therapy, Weight Gain, Counseling, Nutritional Status, Renal Dialysis adverse effects
Abstract

Maintenance hemodialysis outpatients must limit salt and water intake to maintain electrolyte balance and blood pressure. In Kawashima Hospital, nationally registered dietitians provide hemodialysis patients with monthly nutritional counseling. We investigated whether nutritional counseling affects interdialytic weight gain (IDWG) and blood pressure. We investigated 48 hemodialysis patients whose monthly average IDWG ratio to dry weight exceeded 5.1% and who had not had a long-term hospital admittance of > 1 month. After the 48-month nutritional counseling period, the IDWG ratio had improved in 37 of the patients (77.1%), significantly decreasing from 6.0±0.7 to 5.3±0.9%. Estimated salt and water intake decreased significantly from 13.3±2.7 to 11.8±2.4 g/day and 2528±455 to 2332±410 ml/day, respectively. During the intervention period, normalized protein catabolic rate and body mass index did not change substantially. Pre-hemodialysis systolic and diastolic blood pressures had significantly decreased from 149±19 to 134±18 mmHg, and 82±13 to 75±10 mmHg for 48 months after study initiation, respectively. The dosage of antihypertensive drugs had significantly decreased in the group that experienced improvement in the IDWG ratio. Long-term nutritional counseling by nationally registered dietitians may improve the IDWG ratio and blood pressure of hemodialysis patients by decreasing their salt and water intake. J. Med. Invest. 64: 129-135, February, 2017.

Published
2017
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