Koyukai Memorial Hospital

Hanamigawa ku, Japan

Koyukai Memorial Hospital

Hanamigawa ku, Japan
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Iwahori T.,Koyukai Memorial Hospital | Esaki M.,Koyukai Memorial Hospital | Hinoue H.,Inage Hospital | Esaki S.,Koyukai Memorial Hospital | Esaki Y.,Koyukai Memorial Hospital
Clinical and Experimental Nephrology | Year: 2014

Background: Hypoalbuminemia caused by peritoneal dialysate protein loss, frequently occurs in patients on peritoneal dialysis (PD) and is associated with an increased risk of death. We investigate whether PD dialysis exchange volume (PD volume) could be reduced with tolvaptan (TVP) through increased urine volume (UV). Methods: The study included 11 stable patients with oliguria undergoing PD. The following parameters were examined-diuretic response and the effect of TVP on peritoneal ultrafiltration (UF), body weight, serum albumin, sodium, arm muscle area (AMA), PD volume, dialysis efficiency calculator (K t/V), and urine and serum osmolarity (OSM). Results: The average UV increased from 428 ± 178 to 906 ± 285 mL (p = 0.018 by paired t test). Average weekly PD volume decreased from 28,836 ± 5,699 to 23,872 ± 3,569 mL (p = 0.04 by paired t test). Average UF increased from 283 ± 147 to 575 ± 135 mL (p = 0.019 by paired t test). On the other hand, there was no significant difference in the average dialysate K t/V before and after TVP treatment. Serum sodium, AMA, and serum albumin levels were not statistically different before and after TVP treatment. The urine and serum OSM ratio of effective cases before TVP treatment was higher than that of ineffective cases (p = 0.024 by unpaired t test). Conclusion: Our results indicate that TVP is useful for patients on continuous ambulatory PD who have oliguria and high urine osmolarity. Furthermore, we can reduce PD volume to maintain their nutritional status. © 2013 Japanese Society of Nephrology.


PubMed | Morinaga Milk Industry Co., Koyukai Memorial Hospital, Tokyo Medical University, Tokyo Electron and Orimoto Hospital
Type: | Journal: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation | Year: 2016

To evaluate the effects of a nutritional formula enriched with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in tube-fed bedridden hemodialysis patients.A prospective, multicenter, single-arm study.Koyukai Memorial Hospital, Orimoto Hospital, and Chofu Hospital, Japan.Eleven tube-fed bedridden hemodialysis patients.Patients were fed a nutritional formula enriched with EPA and DHA for 12weeks.Body weight; body mass index (BMI); serum levels of total protein, albumin, prealbumin, total cholesterol, triglyceride, and C-reactive protein (CRP); serum fatty acid composition.Body weight; BMI; and serum levels of total protein, albumin, total cholesterol, triglyceride, and CRP at 12weeks were not significantly different from baseline levels. Serum prealbumin, EPA, and DHA levels significantly increased after 12weeks of treatment.A nutritional formula enriched with EPA and DHA may be beneficial for nutritional management in tube-fed bedridden hemodialysis patients.


PubMed | Koyukai Memorial Hospital
Type: Journal Article | Journal: Clinical and experimental nephrology | Year: 2014

Hypoalbuminemia caused by peritoneal dialysate protein loss, frequently occurs in patients on peritoneal dialysis (PD) and is associated with an increased risk of death. We investigate whether PD dialysis exchange volume (PD volume) could be reduced with tolvaptan (TVP) through increased urine volume (UV).The study included 11 stable patients with oliguria undergoing PD. The following parameters were examined-diuretic response and the effect of TVP on peritoneal ultrafiltration (UF), body weight, serum albumin, sodium, arm muscle area (AMA), PD volume, dialysis efficiency calculator (K t/V), and urine and serum osmolarity (OSM).The average UV increased from 428 178 to 906 285 mL (p = 0.018 by paired t test). Average weekly PD volume decreased from 28,836 5,699 to 23,872 3,569 mL (p = 0.04 by paired t test). Average UF increased from 283 147 to 575 135 mL (p = 0.019 by paired t test). On the other hand, there was no significant difference in the average dialysate K t/V before and after TVP treatment. Serum sodium, AMA, and serum albumin levels were not statistically different before and after TVP treatment. The urine and serum OSM ratio of effective cases before TVP treatment was higher than that of ineffective cases (p = 0.024 by unpaired t test).Our results indicate that TVP is useful for patients on continuous ambulatory PD who have oliguria and high urine osmolarity. Furthermore, we can reduce PD volume to maintain their nutritional status.

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