National Hospital Organization Chiba East National Hospital

Chiba, Japan

National Hospital Organization Chiba East National Hospital

Chiba, Japan
SEARCH FILTERS
Time filter
Source Type

Nishimura M.,National Hospital Organization Chiba East National Hospital | Kato Y.,National Hospital Organization Nagoya Medical Center | Tanaka T.,National Hospital Organization Mie Chuo Medical Center | Taki H.,National Hospital Organization Osaka Medical Center | And 6 more authors.
American Journal of Hypertension | Year: 2017

BACKGROUND The Home Blood Pressure for Diabetic Nephropathy study is a prospective observational study conducted to determine the effect of home blood pressure (HBP) on remission/regression of microalbuminuria in patients with type 2 diabetes mellitus (DM). METHODS Patients with type 2 DM having microalbuminuria were followed-up for 3 years. Remission of microalbuminuria was defined as shift from microalbuminuria to normoalbuminuria. Regression of microalbuminuria was defined as a 50% reduction in urinary albumin-creatinine ratio from baseline. All measurements of morning and evening HBP were averaged every year and defined as all HBP. RESULTS In total, 235 patients were followed up. The 3-year cumulative incidences of remission and regression were 32.3% and 44.7%, respectively. Following analysis of all cases, the degree of decline in all home systolic blood pressure (AHSBP), rather than mean AHSBP, influenced the incidence of remission/regression. There was a strong relationship between the decline in AHSBP during the follow-up period and AHSBP at baseline. Therefore, separate analyses of the patients with AHSBP below 140 mm Hg at baseline were performed, which revealed that mean AHSBP during the follow-up period independently affected the incidence of remission/ regression. The hazard ratio for inducing remission/regression was significantly lower in patients with AHSBP during the follow-up period above 130 mm Hg than in those with AHSBP below 120 mm Hg. CONCLUSIONS Optimal AHSBP for the induction of remission/regression of microalbuminuria might be below 130 mm Hg. It is required to confirm whether keeping AHSBP below 130 mm Hg leads to subsequent renoprotection or not. © American Journal of Hypertension, Ltd 2017.


Nishimura M.,National Hospital Organization Chiba East National Hospital | Kato Y.,National Hospital Organization Nagoya Medical Center | Tanaka T.,National Hospital Organization Mie Chuo Medical Center | Todo R.,National Hospital Organization Osaka Medical Center | And 6 more authors.
Hypertension Research | Year: 2013

The Home Blood Pressure for Diabetic Nephropathy (HBP-DN) study is a prospective cohort study to determine the optimal home blood pressure (HBP) required to improve the prognosis of type 2 diabetic patients with microalbuminuria. The glomerular filtration rate (GFR) is heterogeneous in microalbuminuric diabetic patients. The first step of the HBP-DN study explored the significance of estimating GFR for the identification of patients for whom HBP measurement would be more helpful. The patients were divided into two groups based on their estimated GFR (eGFR): a low eGFR group (eGFR <60 ml min -1 per 1.73 m2, N=75) and a preserved eGFR group (eGFR ≥60 ml min-1 per 1.73 m2, N=193). HBP, variability of HBP and a previous history of vascular complications were compared between the two groups. The number of antihypertensive drugs used for the patients and the s.d. of home systolic blood pressure (HSBP) in the low eGFR group were significantly higher than those in the preserved eGFR group. A stepwise multiple linear regression analysis also revealed that the low eGFR group was independently correlated with the s.d. of HSBP. A multiple logistic regression analysis revealed that a low eGFR was an independent risk factor for coronary heart disease and advanced retinopathy. Estimating the GFR is important to identify patients with elevated blood pressure variability, as well as those with a high risk of vascular complications. Measuring HBP would be more helpful for the effective and safe treatment of hypertension in patients with a low eGFR than in those with a preserved eGFR. © 2013 The Japanese Society of Hypertension. All rights reserved.


Komatsu H.,University of Miyazaki | Fujimoto S.,University of Miyazaki | Yoshikawa N.,Center for Clinical Research and Development | Kitamura H.,National Hospital Organization Chiba East National Hospital | And 2 more authors.
Clinical and Experimental Nephrology | Year: 2015

Background: The clinical presentation of Henoch–Schönlein purpura nephritis (HSPN) has not been thoroughly investigated among patients of different ages. We therefore compared the features of HSPN and IgA nephropathy (IgAN) based on data from the Japan Renal Biopsy Registry (J-RBR). Methods: This cross-sectional study analyzed data from patients who were registered in the J-RBR between 2007 and 2012. Clinico-pathological findings at diagnosis were compared among children (aged ≤18 years), adult (aged 19–64 years) and elderly (aged ≥65 years) patients with HSPN (n = 513) and IgAN (n = 5679). Results: The age at diagnosis considerably differed between HSPN and IgAN; HSPN peaked at 1–19 and at 60–69 years, whereas IgAN peaked at 30–39 years. The clinical features were significantly more severe for HSPN than IgAN, especially proteinuria (children, 1.28 vs. 0.57; adult, 1.95 vs. 1.05; elderly patients, 2.71 vs. 1.64 g/day), and low albumin levels (children, 3.72 vs. 4.13; adults, 3.62 vs. 3.99; elderly patients, 3.07 vs. 3.57 g/dL). The rate (%) of histologically classified endocapillary proliferative or crescentic glomerulonephritis was higher in patients with HSPN than with IgAN. Multiple regression analysis revealed that low albumin level and high BP were independent factors associated with decreased estimated glomerular filtration rates in adult and elderly patients with HSPN. Conclusions: Age at HSPN diagnosis was bimodally distributed, and the clinical features of HSPN were more severe than those of IgAN across all age groups. © 2015 The Author(s)


Yonekura Y.,Kobe University | Goto S.,Kobe University | Sugiyama H.,Okayama University of Science | Kitamura H.,National Hospital Organization Chiba East National Hospital | And 2 more authors.
Clinical and Experimental Nephrology | Year: 2015

Background: This study aimed to describe the influences of larger physical constitutions including obesity on the amount of urine protein excretion (AUPE) in primary glomerulonephritis. The distinct effects on the AUPE in various types of glomerulonephritis were evaluated. Methods: Using the database of the Japan Renal Biopsy Registry (J-RBR) from 2007 to 2010, 4060 cases with primary glomerulonephritis including MCNS, FSGS, MN, MPGN, IgAN, and non-IgA were reviewed. The AUPEs were compared between high and low Body Mass Index (BMI) groups, and larger and smaller body surface area (BSA) groups using the indexes of BMI 25.0 kg/m2 and BSA 1.73 m2 in all cases and in each histological group. Multivariable analysis was performed to evaluate the predominant contributors to the AUPE. Results: The larger physical constitution groups (BMI ≥25.0 kg/m2 or BSA ≥1.73 m2) had significantly higher AUPEs in all cases with primary glomerulonephritis. When compared in each histological group, the mean AUPEs were significantly higher in the larger physical constitution groups, excluding the FSGS and non-IgA groups. Multiple regression analysis revealed that the significant contributors to the AUPE were BMI and BSA in MCNS and MN, whereas BMI and BSA were not significant and mean blood pressure and serum creatinine were significant in FSGS and non-IgA. Conclusion: Larger physical constitutions including obesity had a significant impact on the increase in the AUPE in primary glomerulonephritis, especially in MCNS and MN. However, FSGS and non-IgA were distinct for having blood pressure and renal dysfunction as possibly the major causes of proteinuria. © 2014, Japanese Society of Nephrology.


PubMed | National Hospital Organization Chiba East National Hospital, Kanazawa Medical University, Okayama University of Science and Kobe University
Type: Journal Article | Journal: Clinical and experimental nephrology | Year: 2015

This study aimed to describe the influences of larger physical constitutions including obesity on the amount of urine protein excretion (AUPE) in primary glomerulonephritis. The distinct effects on the AUPE in various types of glomerulonephritis were evaluated.Using the database of the Japan Renal Biopsy Registry (J-RBR) from 2007 to 2010, 4060 cases with primary glomerulonephritis including MCNS, FSGS, MN, MPGN, IgAN, and non-IgA were reviewed. The AUPEs were compared between high and low Body Mass Index (BMI) groups, and larger and smaller body surface area (BSA) groups using the indexes of BMI 25.0 kg/m(2) and BSA 1.73 m(2) in all cases and in each histological group. Multivariable analysis was performed to evaluate the predominant contributors to the AUPE.The larger physical constitution groups (BMI 25.0 kg/m(2) or BSA 1.73 m(2)) had significantly higher AUPEs in all cases with primary glomerulonephritis. When compared in each histological group, the mean AUPEs were significantly higher in the larger physical constitution groups, excluding the FSGS and non-IgA groups. Multiple regression analysis revealed that the significant contributors to the AUPE were BMI and BSA in MCNS and MN, whereas BMI and BSA were not significant and mean blood pressure and serum creatinine were significant in FSGS and non-IgA.Larger physical constitutions including obesity had a significant impact on the increase in the AUPE in primary glomerulonephritis, especially in MCNS and MN. However, FSGS and non-IgA were distinct for having blood pressure and renal dysfunction as possibly the major causes of proteinuria.


PubMed | University of Miyazaki, Center for Clinical Research and Development, National Hospital Organization Chiba East National Hospital, Okayama University of Science and Kanazawa Medical University
Type: Journal Article | Journal: Clinical and experimental nephrology | Year: 2016

The clinical presentation of Henoch-Schnlein purpura nephritis (HSPN) has not been thoroughly investigated among patients of different ages. We therefore compared the features of HSPN and IgA nephropathy (IgAN) based on data from the Japan Renal Biopsy Registry (J-RBR).This cross-sectional study analyzed data from patients who were registered in the J-RBR between 2007 and 2012. Clinico-pathological findings at diagnosis were compared among children (aged 18years), adult (aged 19-64years) and elderly (aged 65years) patients with HSPN (n=513) and IgAN (n=5679).The age at diagnosis considerably differed between HSPN and IgAN; HSPN peaked at 1-19 and at 60-69years, whereas IgAN peaked at 30-39years. The clinical features were significantly more severe for HSPN than IgAN, especially proteinuria (children, 1.28 vs. 0.57; adult, 1.95 vs. 1.05; elderly patients, 2.71 vs. 1.64g/day), and low albumin levels (children, 3.72 vs. 4.13; adults, 3.62 vs. 3.99; elderly patients, 3.07 vs. 3.57g/dL). The rate (%) of histologically classified endocapillary proliferative or crescentic glomerulonephritis was higher in patients with HSPN than with IgAN. Multiple regression analysis revealed that low albumin level and high BP were independent factors associated with decreased estimated glomerular filtration rates in adult and elderly patients with HSPN.Age at HSPN diagnosis was bimodally distributed, and the clinical features of HSPN were more severe than those of IgAN across all age groups.


Kuroda F.,Chibaken Saiseikai Narashino Hospital | Kuroda F.,Chiba University | Tanabe N.,Chiba University | Igari H.,National Hospital Organization Chiba East National Hospital | And 5 more authors.
Internal Medicine | Year: 2014

Objective: We aimed to investigate the incidence and clinical characteristics of nontuberculous mycobacterial (NTM) pulmonary disease as a complication of chronic thromboembolic pulmonary hypertension (CTEPH).Methods: We conducted a retrospective study of 10 cases (5.6%) complicated by NTM pulmonary disease among 180 CTEPH patients.Results: Isolated species of avium (n=5), kansasii (n=2), intracellulare (n=1), abscessus (n=1) and fortuitum (n=1) were detected. NTM-infected lesions were observed in 33 of 180 (18.3%) lung segments obtained from the 10 patients, and complete obstruction due to chronic pulmonary thromboembolism was detected in 65 of the 180 segmental pulmonary arteries (36.1%). The NTM-infected segments in the CTEPH patients were significantly associated with obstructed rather than unobstructed pulmonary artery segments [25 of 65 (38.5%) vs. 8 of 115 (6.9%), p<0.01]. Cavitary, nodular, ectatic and ground-glass lesions were seen in 14, 22, seven and four of the 180 segments, respectively. Thirteen of the 14 cavitary (92.9%) lesions were located in nonperfused segments. Five patients with NTM disease underwent pulmonary endarterectomy (PEA). Of the 18 assessable NTM-infected segments in six NTM-treated patients, 17 were located in non-perfused segments and one was located in a previously perfused segment. All NTM-infected segments improved among three segments reperfused with PEA. In contrast, only eight (57.1%) NTM-infected segments improved among 14 continuously non-perfused segments. A lower body mass index was found to be a significant risk factor for NTM disease in the CTEPH patients.Conclusion: This is the first report to document NTM-disease complications in patients with CTEPH. Reperfusion in cases of NTM lesions may improve the response to NTM drug therapy. © 2014 The Japanese Society of Internal Medicine.


Tanaka S.,Chiba University | Suto A.,Chiba University | Ikeda K.,Chiba University | Sanayama Y.,Chiba University | And 9 more authors.
Rheumatology (United Kingdom) | Year: 2013

Objective. Although several miRNAs have been shown to regulate autoimmune pathogenesis by affecting lymphocyte function, the roles of miRNAs in the pathogenesis of SSc remain unclear. Therefore the purpose of this study was to identify miRNAs that play a role in the pathogenesis of SSc by quantitative PCR screening of serum miRNAs. Methods. Ninety-five miRNAs that were predicted to target SSc-related genes [IL-4, TGF-β, CTGF, PDGFB, PDGF receptor (PDGFR) α/β and COL1A2] by in silico analyses were selected. The expression of these miRNAs in sera of SSc patients and healthy controls was measured by quantitative PCR. Involvement of miR-30b, which was most strongly down-regulated in SSc patients, in the regulation of PDGFR-β expression was examined by transfection experiments and 3'-untranslated region (3'-UTR) target luciferase assays. The expression of miR-30b in skin was evaluated in a bleomycin-induced dermal fibrosis model in mice and in SSc patients. Results. Nineteen of 95 miRNAs were significantly decreased in the sera of SSc patients. Among them, miR-30b was most strongly down-regulated in SSc patients (P = 0.00006) and the levels of miR-30b were inversely correlated with modified Rodnan skin scores. Transfection of a miR-30b mimic repressed PDGFR-β expression in dermal fibroblasts and the activity of a luciferase reporter containing 3'-UTR of PDGFR-β. Moreover, the expression of miR-30b was down-regulated in bleomycin-treated sclerotic skin and in affected skin in SSc patients. Conclusion. Down-regulation of miR-30b might be involved in the pathogenesis of SSc. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.


PubMed | National Hospital Organization Chiba East National Hospital
Type: Case Reports | Journal: General thoracic and cardiovascular surgery | Year: 2012

A 63-year-old man with a history of lung cancer underwent lobectomy of the right upper lobe and bronchoplasty. At the 2-month follow-up, bronchial stenosis due to a granuloma was observed. Endoscopic dbridement and balloon dilation were performed. At 1 month after the dilation, atelectasis occurred owing to cicatricial stenosis. We repeated balloon dilation, but the patient suffered from cicatricial restenosis. After a failed stent placement, balloon dilation was then performed every 2 weeks under local anesthesia; the stenosis was resolved after performing dilation 7 times. Short-term repeated balloon dilation was effective in this case.


PubMed | National Hospital Organization Chiba East National Hospital
Type: Journal Article | Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy | Year: 2013

Low birth weight (LBW) is thought to be one of the risk factors for the progression of kidney diseases. This study hypothesized that the onset age of kidney disease, the rate of progression of kidney disease, or the age at the time of hemodialysis (HD) induction among HD patients that were born with LBW is different from those without a history of LBW. A questionnaire survey in nine dialysis units in Japan was performed and 427 answer sheets were collected. There were statistically significant differences in the present age, the age of kidney disease onset, and the age of HD induction between LBW group and normal birth weight group (NBW). An analysis limited to participants whose underlying disease was diabetic nephropathy revealed that the duration from the onset of nephropathy to HD induction was much shorter in HD patients with a history of LBW than those with a NBW history. In addition, the Pearsons correlation coefficient between the birth weight and the period from onset of diabetic nephropathy to HD induction was 0.283. Although these results might partly support the primary hypothesis, the necessity to perform other clinical studies is also emphasized.

Loading National Hospital Organization Chiba East National Hospital collaborators
Loading National Hospital Organization Chiba East National Hospital collaborators