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Keiji Hirai,1 Masako Shimotashiro,2 Toshiaki Okumura,2 Susumu Ookawara,1 Yoshiyuki Morishita1 1Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan; 2Mizue Yuai Clinic, Tokyo, JapanCorrespondence: Keiji Hirai, Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan, Tel +81-48-647-2111, Fax +81-48-647-6831, Email keijihirai@kfy.biglobe.ne.jpBackground: We assessed the anti-SARS-CoV-2 spike antibody response to four doses of BNT162b2 mRNA COVID-19 vaccine in Japanese hemodialysis patients and determined factors associated with the anti-SARS-CoV-2 spike antibody titer after the fourth dose.Methods: Fifty-one patients were enrolled in this single-center, prospective, longitudinal study. Change in anti-SARS-CoV-2 spike antibody titers between after the second and fourth doses were evaluated. Multiple linear regression analysis was used to identify factors associated with the anti-SARS-CoV-2 spike antibody titer after the fourth dose.Results: The anti-SARS-CoV-2 spike antibody titer was higher 4 weeks after the fourth dose compared with 4 weeks after the third dose (30,000 [interquartile range (IQR), 14,000– 56,000] vs 18,000 [IQR, 11,000– 32,500] AU/mL, p< 0.001) and 4 weeks after the second dose (vs 2896 [IQR, 1110– 4358] AU/mL, p< 0.001). Hypoxia-inducible factor prolyl hydroxylase inhibitor use (standard coefficient [β]=0.217, p=0.011), and the log-anti-SARS-CoV-2 spike antibody titer 1 week before the fourth dose (β=0.810, p< 0.001) were correlated with the log-anti-SARS-CoV-2 spike antibody titer 4 weeks after the fourth dose, whereas only the log-anti-SARS-CoV-2 spike antibody titer 1 week before the fourth dose (β=0.677, p< 0.001) was correlated with the log-anti-SARS-CoV-2 spike antibody titer 12 weeks after the fourth dose.Conclusion: Hypoxia-inducible f

Katsunori Yanai, Keiji Hirai, Shohei Kaneko, Yuko Mutsuyoshi, Taisuke Kitano, Haruhisa Miyazawa, Kiyonori Ito, Yuichiro Ueda, Susumu Ookawara, Yoshiyuki Morishita Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JapanCorrespondence: Keiji Hirai, Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama-shi, Saitama-ken, 330-8503, Japan, Tel +81-48-647-2111, Fax +81-48-647-6831, Email keijihirai@kfy.biglobe.ne.jpObjective: We investigated the efficacy and safety of dotinurad, a selective urate reabsorption inhibitor, in hyperuricemic patients with advanced chronic kidney disease (CKD) (stage G3-5).Patients and Methods: We retrospectively analyzed the cases of 34 patients (mean age, 68.6 ±  13.3 years; 17 men and 17 women) after 12 months of dotinurad treatment based on the changes in uric acid (UA) and the urine protein-to-creatinine ratio (UPCR) plus the annual change in estimated glomerular filtration rate (eGFR). Hyperuricemia (UA ≥ 6.0 mg/dL) and advanced CKD (mean eGFR: 32.0 ± 13.3 mL/min/1.73m2; stage G3, n=17; G4, n=13; G5, n=4) were present in all of the patients. The cases of 34 matched individuals with similar propensity scores (who were not taking dotinurad) were analyzed as a control group.Results: UA values decreased significantly in the dotinurad group (7.1 ±  0.8 mg/dL to 5.9 ±  1.0 mg/dL, p< 0.05) but those did not change in the control group. UPCR did not change in either group. Low-density lipoprotein cholesterol also decreased significantly in the dotinurad group (98.8 ±  43.4 mg/dL to 82.9 ±  33.1 mg/dL, p< 0.05). With the 12-month dotinurad treatment, the annual change in the patients’ eGFR was significantly improved from − 6.0 ±  12.9 mL/min/1.73 m2/year to − 0.9 ±  4.6 mL/min/1.73 m2/year (p< 0.05), but there was no change in

Shohei Kaneko, Susumu Ookawara, Yoshiyuki Morishita Department of Nephrology, Jichi Medical University Saitama Medical Center, Saitama, JapanCorrespondence: Yoshiyuki Morishita, Department of Nephrology, Jichi Medical University Saitama Medical Center, Saitama, Japan, Tel +81-48-647-2111, Fax +81-48-647-6831, Email ymori@jichi.ac.jpPurpose: Magnesium (Mg) is an essential element that is associated with various physiological functions, such as maintenance of blood pressure, muscle contraction, and nerve function. In patients undergoing hemodialysis, hypomagnesemia is associated with cardiovascular and all-cause mortality. However, in patients undergoing peritoneal dialysis (PD), clinical factors associated with Mg have not been fully investigated.Patients and Methods: Clinical factors including anthropometric data, comorbidities, laboratory data, medications, and dialysis methods were collected from the medical records of patients undergoing PD. The associations of these factors with the serum Mg concentration were investigated by univariate and multivariate analyses.Results: Sixty patients undergoing PD were investigated. The univariate analysis showed that the serum Mg concentration was significantly associated with treatment by hybrid PD (daily PD + once-weekly hemodialysis) (β = 0.264, P = 0.04), administration of phosphate binders (β = 0.294, P = 0.02), the serum C-reactive protein concentration (β = − 0.318, P = 0.01), the serum potassium (K) concentration (β = 0.451, P < 0.01), and the serum intact parathormone concentration (β = − 0.333, P = 0.01). The multivariate analysis using these factors showed an independent association between the serum Mg and K concentrations (β = 0.333, P = 0.01).Conclusion: The serum Mg concentration was independently associated with the serum K concentration in patients undergoing PD.Keywords: peritoneal dialysis, magnesium, phosphate binder, potassium, intact parathormone