研究者詳細 - 内田　治仁

論文 - 内田　治仁

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検尿異常の精査中に発見したIgA腎症に腎性低尿酸血症が合併した1例

櫻武敬真, 内田治仁, 田原稔久, 山崎遥香, 大西康博, 田中景子, 竹内英実, 辻憲二, 梅林亮子, 和田淳

日本腎臓学会誌 65 ( 6-W ) 810 - 810 2023年9月

Cronkhite-Canada症候群に膜性腎症を合併した1例

中納弘幸, 森本志帆, 辻憲二, 田邊克幸, 内田治仁, 和田淳

日本腎臓学会誌 65 ( 6-W ) 767 - 767 2023年9月

Elderly Brothers With Fabry Disease Exhibiting Cardiac and Renal Manifestations

Keiko Tanaka, Hitoshi Sugiyama, Hiroshi Morinaga, Akifumi Onishi, Yuzuki Kano, Hidemi Takeuchi, Kenji Tsuji, Motoki Kubo, Katsuyuki Tanabe, Haruhito A. Uchida, Kazufumi Nakamura, Jun Wada

Annals of Internal Medicine: Clinical Cases 2 ( 5 ) 2023年5月

岡山市CKDネットワーク(OCKD-NET)2の登録時データ解析 OCKD-NET1との比較

田中景子, 内田治仁, 大西康博, 岡本修吾, 竹内英実, 辻憲二, 田邊克幸, 森永裕士, 太田康介, 丸山啓輔, 大城義之, 森岡茂, 瀧上慶一, 蒲生直幸, 杉山斉, 和田淳

日本腎臓学会誌 65 ( 3 ) 268 - 268 2023年5月

岡山市CKDネットワーク(OCKD-NET)におけるCKD病診連携12年後の追跡調査

大西康博, 内田治仁, 田中景子, 岡本修吾, 竹内英実, 辻憲二, 田邊克幸, 森永裕士, 喜多村真治, 前島洋平, 太田康介, 丸山啓輔, 大城義之, 森岡茂, 瀧上慶一, 蒲生直幸, 杉山斉, 和田淳

日本腎臓学会誌 65 ( 3 ) 240 - 240 2023年5月

医学生に対する腎セミナー開催についての検討

辻憲二, 岡本修吾, 大西康博, 田中景子, 竹内英実, 田邊克幸, 森永裕士, 内田治仁, 喜多村真治, 和田淳

日本腎臓学会誌 65 ( 3 ) 326 - 326 2023年5月

岡山市CKDネットワーク(OCKD-NET)2の登録時データ解析 OCKD-NET1との比較

日本腎臓学会誌 65 ( 3 ) 268 - 268 2023年5月

岡山市CKDネットワーク(OCKD-NET)におけるCKD病診連携12年後の追跡調査

日本腎臓学会誌 65 ( 3 ) 240 - 240 2023年5月

医学生に対する腎セミナー開催についての検討

辻憲二, 岡本修吾, 大西康博, 田中景子, 竹内英実, 田邊克幸, 森永裕士, 内田治仁, 喜多村真治, 和田淳

日本腎臓学会誌 65 ( 3 ) 326 - 326 2023年5月

The Effect of Medical Cooperation in the CKD Patients: 10-Year Multicenter Cohort Study. 国際誌

Yasuhiro Onishi, Haruhito A Uchida, Yohei Maeshima, Yuka Okuyama, Nozomu Otaka, Haruyo Ujike, Keiko Tanaka, Hidemi Takeuchi, Kenji Tsuji, Masashi Kitagawa, Katsuyuki Tanabe, Hiroshi Morinaga, Masaru Kinomura, Shinji Kitamura, Hitoshi Sugiyama, Kosuke Ota, Keisuke Maruyama, Makoto Hiramatsu, Yoshiyuki Oshiro, Shigeru Morioka, Keiichi Takiue, Kazuyoshi Omori, Masaki Fukushima, Naoyuki Gamou, Hiroshi Hirata, Ryosuke Sato, Hirofumi Makino, Jun Wada

Journal of personalized medicine 13 ( 4 ) 2023年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: While chronic kidney disease (CKD) is one of the most important contributors to mortality from non-communicable diseases, the number of nephrologists is limited worldwide. Medical cooperation is a system of cooperation between primary care physicians and nephrological institutions, consisting of nephrologists and multidisciplinary care teams. Although it has been reported that multidisciplinary care teams contribute to the prevention of worsening renal functions and cardiovascular events, there are few studies on the effect of a medical cooperation system. METHODS: We aimed to evaluate the effect of medical cooperation on all-cause mortality and renal prognosis in patients with CKD. One hundred and sixty-eight patients who visited the one hundred and sixty-three clinics and seven general hospitals of Okayama city were recruited between December 2009 and September 2016, and one hundred twenty-three patients were classified into a medical cooperation group. The outcome was defined as the incidence of all-cause mortality, or renal composite outcome (end-stage renal disease or 50% eGFR decline). We evaluated the effects on renal composite outcome and pre-ESRD mortality while incorporating the competing risk for the alternate outcome into a Fine-Gray subdistribution hazard model. RESULTS: The medical cooperation group had more patients with glomerulonephritis (35.0% vs. 2.2%) and less nephrosclerosis (35.0% vs. 64.5%) than the primary care group. Throughout the follow-up period of 5.59 ± 2.78 years, 23 participants (13.7%) died, 41 participants (24.4%) reached 50% decline in eGFR, and 37 participants (22.0%) developed end-stage renal disease (ESRD). All-cause mortality was significantly reduced by medical cooperation (sHR 0.297, 95% CI 0.105-0.835, p = 0.021). However, there was a significant association between medical cooperation and CKD progression (sHR 3.069, 95% CI 1.225-7.687, p = 0.017). CONCLUSION: We evaluated mortality and ESRD using a CKD cohort with a long-term observation period and concluded that medical cooperation might be expected to influence the quality of medical care in the patients with CKD.

DOI： 10.3390/jpm13040582

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Serum sCD40L and IL-31 in Association with Early Phase of IgA Nephropathy. 国際誌

Keiko Tanaka, Hitoshi Sugiyama, Hiroshi Morinaga, Masashi Kitagawa, Yuzuki Kano, Yasuhiro Onishi, Koki Mise, Katsuyuki Tanabe, Haruhito A Uchida, Jun Wada

Journal of clinical medicine 12 ( 5 ) 2023年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: IgA nephropathy (IgAN) is a major cause of chronic glomerulonephritis worldwide. T cell dysregulation has been reported to contribute to the pathogenesis of IgAN. Methods We measured a broad range of Th1, Th2 and Th17 cytokines in the serum of IgAN patients. We searched for significant cytokines, which were associated with clinical parameters and histological scores in IgAN patients. RESULTS: Among 15 cytokines, the levels of soluble CD40L (sCD40L) and IL-31 were higher in IgAN patients and were significantly associated with a higher estimated glomerular filtration rate (eGFR), a lower urinary protein to creatinine ratio (UPCR), and milder tubulointerstitial lesions (i.e., the early phase of IgAN). Multivariate analysis revealed that serum sCD40L was an independent determinant of a lower UPCR after adjustment for age, eGFR, and mean blood pressure (MBP). CD40, a receptor of sCD40L, has been reported to be upregulated on mesangial cells in IgAN. The sCD40L/CD40 interaction may directly induce inflammation in mesangial areas and may therefore be involved in the development of IgAN. CONCLUSIONS: The present study demonstrated the significance of serum sCD40L and IL-31 in the early phase of IgAN. Serum sCD40L may be a marker of the beginning of inflammation in IgAN.

DOI： 10.3390/jcm12052023

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Association between Urinary Creatinine Excretion and Hypothyroidism in Patients with Chronic Kidney Disease. 国際誌

Natsumi Matsuoka-Uchiyama, Kenji Tsuji, Kensaku Takahashi, Kazuhiko Fukushima, Hidemi Takeuchi, Shinji Kitamura, Kenichi Inagaki, Haruhito A Uchida, Jun Wada

Diagnostics (Basel, Switzerland) 13 ( 4 ) 2023年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

While hypothyroidism increases serum creatinine (Cr) levels, it is uncertain whether the elevation is mediated via a decline in the glomerular filtration rate (GFR) or the reflection of enhanced Cr production from the muscles or both. In the present study, we explored an association between urinary Cr excretion rate (CER) and hypothyroidism. A total of 553 patients with chronic kidney disease were enrolled in a cross-sectional study. Multiple linear regression analysis was performed to explore the association between hypothyroidism and urinary CER. The mean urinary CER was 1.01 ± 0.38 g/day and 121 patients (22%) had hypothyroidism. The multiple linear regression analysis revealed explanatory variables with urinary CER, including age, sex, body mass index, 24 h Cr clearance (24hrCcr), and albumin while hypothyroidism was not considered an independent explanatory variable. In addition, scatter plot analysis with regression fit line representing the association between estimated GFR calculated using s-Cr (eGFRcre) and 24hrCcr revealed that eGFRcre and 24hrCcr had strong correlations with each other in hypothyroid patients as well as euthyroid patients. Collectively, hypothyroidism was not considered an independent explanatory variable for urinary CER in the present study and eGFRcre is a useful marker to evaluate kidney function regardless of the presence of hypothyroidism.

DOI： 10.3390/diagnostics13040669

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Efficacy and Safety of Esaxerenone in Hypertensive Patients with Diabetic Kidney Disease: A Multicenter, Open-Label, Prospective Study. 国際誌

Haruhito A Uchida, Hirofumi Nakajima, Masami Hashimoto, Akihiko Nakamura, Tomokazu Nunoue, Kazuharu Murakami, Takeshi Hosoya, Kiichi Komoto, Takashi Taguchi, Takaaki Akasaka, Kazuhito Shiosakai, Kotaro Sugimoto, Jun Wada

Advances in therapy 39 ( 11 ) 5158 - 5175 2022年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Clinical data of esaxerenone in hypertensive patients with diabetic kidney disease (DKD) are lacking. We evaluated the efficacy and safety of esaxerenone in patients with DKD and an inadequate response to blood pressure (BP)-lowering treatment. METHODS: In this multicenter, open-label, prospective study, patients were divided into urinary albumin-to-creatinine ratio subcohorts (UACR < 30, 30 to < 300, and 300 to < 1000 mg/gCr). Esaxerenone was initiated at 1.25 mg/day and followed by incremental dose escalation based on BP and serum potassium level monitoring. The treatment period was 12 weeks. The primary endpoint was change in morning home systolic BP/diastolic BP (SBP/DBP) from baseline to end of treatment (EOT). Secondary endpoints included achievement rate of target BP, change in UACR from baseline, and safety. RESULTS: In total, 113 patients were enrolled. Morning home SBP/DBP significantly decreased from baseline to EOT in the total population (- 11.6/- 5.2 mmHg, both p < 0.001) and in all UACR subcohorts (all p < 0.001). The target BP achievement rate was 38.5%. Significant reductions in bedtime home and office BPs were also shown in the total population and all UACR subcohorts. UACR significantly improved from baseline to EOT in the total (- 50.9%, p < 0.001) and all UACR subcohorts (all p < 0.001). Incidence of serum potassium elevation as drug-related treatment emergent adverse events was 2.7%. The change from baseline in estimated glomerular filtration rate (eGFR) was - 4.8 mL/min/1.73 m2. CONCLUSION: Esaxerenone demonstrated a BP-lowering effect and improved albuminuria. The effects were consistent regardless of the severity of albuminuria without clinically relevant serum potassium elevation and eGFR reduction. CLINICAL TRIAL REGISTRATION: jRCTs06119002.

DOI： 10.1007/s12325-022-02294-z

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The Beneficial Effect of Personalized Lifestyle Intervention in Chronic Kidney Disease Follow-Up Project for National Health Insurance Specific Health Checkup: A Five-Year Community-Based Cohort Study. 国際誌

Hidemi Takeuchi, Haruhito A Uchida, Katsuyoshi Katayama, Natsumi Matsuoka-Uchiyama, Shugo Okamoto, Yasuhiro Onishi, Yuka Okuyama, Ryoko Umebayashi, Kodai Miyaji, Akiko Kai, Izumi Matsumoto, Keiko Taniguchi, Fukiko Yamashita, Tsutomu Emi, Hitoshi Sugiyama, Jun Wada

Medicina (Kaunas, Lithuania) 58 ( 11 ) 2022年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background and Objectives: Mimasaka city is a relatively small city with a population of 28,381, and an aging rate (≥65 years old) of 38.9%, where only one nephrology clinic is available. Since 2013, the city has conducted its own unique lifestyle intervention for the participants of the National Health Insurance specific medical health checkup, aiming to prevent the progression of chronic kidney disease (CKD) severity. Materials and Methods: The persons in National Health Insurance specific medical health checkup (40-74 years old) conducted in Mimasaka city in 2013, with eGFR less than 50 mL/min/1.73 m² or 50-90 mL/min/1.73 m² with urine dipstick protein 1+ or more, were registered for the CKD follow-up project, as high-risk subjects for advanced renal dysfunction. Municipal workers directly visited the subjects' homes to provide individual health guidance and encourage medical consultation. We aimed to examine the effect of home-visit intervention on the changes of renal function and related factors until 2017. Results: The number of the high-risk subjects who continuously received the health checkup until 2017 was 63, and only 23 (36.5%) visited a medical institution in the first year. The eGFR decreased by only 0.4 mL/min/1.73 m²/year, and the subjects with urinary protein 1+ or higher decreased significantly from 20 (31.7%) to 9 (14.3%) (p = 0.034) in the high-risk subjects. The changes in eGFR and urinary protein was almost in the same fashion regardless of their medical institution visits. Next, we examined the effects of various factors on ΔeGFR, the changes of eGFR from 2013 to 2017, by multivariate linear regression analysis. The effects of medical institution visit were not significant, and the degree of urinary protein (coefficient B: 4.503, β: 0.705, p < 0.001), age (coefficient B: 4.753, β: 0.341, p = 0.004), and smoking (coefficient B: 5.878, β: 0.295, p = 0.031) had independent significant effects, indicating that they were the factors exacerbating the decrease in eGFR from the baseline. Conclusions: The personalized lifestyle intervention by home-visit in CKD follow-up project showed the possibility of beneficial effects on the deterioration of renal function. This may be an efficient method to change behavior in a small community with limited medical resources.

DOI： 10.3390/medicina58111529

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Association between the patterns of large-vessel lesions and treatment outcomes in patients with large-vessel giant cell arteritis. 国際誌

Takahiko Sugihara, Haruhito A Uchida, Hajime Yoshifuji, Yasuhiro Maejima, Taio Naniwa, Yasuhiro Katsumata, Takahiro Okazaki, Jun Ishizaki, Yohko Murakawa, Noriyoshi Ogawa, Hiroaki Dobashi, Tetsuya Horita, Yoshiya Tanaka, Shunsuke Furuta, Tsutomu Takeuchi, Yoshinori Komagata, Yoshikazu Nakaoka, Masayoshi Harigai

Modern rheumatology 2022年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: We aimed to identify associations between patterns of large-vessel lesions of large-vessel giant cell arteritis (LV-GCA) and treatment outcomes. METHODS: We extracted data on 68 newly-diagnosed patients with LV-GCA from a retrospective, multi-centric, nationwide registry of GCA patients treated with glucocorticoids between 2007 and 2014. Patients with aortic lesions were identified based on findings from contrast-enhanced computed tomography (CT), magnetic resonance imaging, or positron emission tomography-CT (group 2, n=49). Patients without aortic lesions were subdivided into LV-GCA with or without subclavian lesions defined as group 1 (n=9) or group 3 (n=10), respectively. Primary outcome evaluation was failure to achieve clinical remission by week 24 and/or relapse within 104 weeks. RESULTS: The mean age and proportion of patients with cranial lesions and polymyalgia rheumatica in group 2 was numerically lower than in the other two groups. Large-vessel lesions in group 3 included carotid, pulmonary, renal, hepatic or mesenteric lesions. The cumulative rate of poor treatment outcomes over two years was 11.1%, 55.3%, and 88.0% in groups 1, 2, and 3, respectively (by Kaplan-Meier analysis). The mean time to poor outcome was significantly different between the groups. CONCLUSIONS: Classification by subclavian and aortic lesions may be useful to determine treatment strategy.

DOI： 10.1093/mr/roac122

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異なる経過をたどった腎動脈狭窄を伴う高安動脈炎の2症例

武本梨佳, 内田治仁, 戸田洋伸, 岡本修吾, 竹内英実, 梅林亮子, 大塚文男, 伊藤浩, 和田淳

脈管学 62 ( Suppl. ) S195 - S195 2022年10月

ベーチェット病により腎動脈狭窄症をきたした1例

内田治仁, 戸田洋伸, 武本梨佳, 岡本修吾, 竹内英実, 梅林亮子, 和田淳

脈管学 62 ( Suppl. ) S182 - S183 2022年10月

当院における腎移植後コロナウイルス感染症の臨床経過

吉永香澄, 関戸崇了, 丸山雄樹, 山野井友昭, 西村慎吾, 竹内英実, 田邉克幸, 森永裕士, 内田治仁, 和田淳, 枝村康平, 小林知子, 小林泰之, 荒木元朗

移植 57 ( 総会臨時 ) 262 - 262 2022年10月

異なる経過をたどった腎動脈狭窄を伴う高安動脈炎の2症例

武本梨佳, 内田治仁, 戸田洋伸, 岡本修吾, 竹内英実, 梅林亮子, 大塚文男, 伊藤浩, 和田淳

脈管学 62 ( Suppl. ) S195 - S195 2022年10月

The association between hypothyroidism and proteinuria in patients with chronic kidney disease: a cross-sectional study. 国際誌

Natsumi Matsuoka-Uchiyama, Kenji Tsuji, Yizhen Sang, Kensaku Takahashi, Kazuhiko Fukushima, Hidemi Takeuchi, Kenichi Inagaki, Haruhito A Uchida, Shinji Kitamura, Hitoshi Sugiyama, Jun Wada

Scientific reports 12 ( 1 ) 14999 - 14999 2022年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

Hypothyroidism is known to be correlated with kidney function and nephrotic range proteinuria. However, it is uncertain whether non-nephrotic proteinuria is associated with hypothyroidism. This study aimed to evaluate the association of proteinuria and hypothyroidism in chronic kidney disease (CKD) patients. We conducted a cross-sectional study composed of 421 CKD patients in a single hospital with measurements of 24-h urine protein excretion (UP) and thyroid function tests. Spearman correlation analysis revealed that 24-h Cr clearance (24hrCcr) was positively (r = 0.273, p < 0.001) and UP was negatively (r = - 0.207, p < 0.001) correlated with free triiodothyronine. Frequency distribution analysis stratified by CKD stage and UP for hypothyroidism revealed that the prevalence of hypothyroidism was higher among participants with higher CKD stage and nephrotic range proteinuria. Multivariate logistic regression analysis revealed that 24hrCcr and UP were significantly correlated with hypothyroidism (24hrCcr/10 mL/min decrease: odds ratio [OR], 1.29; 95% confidence interval [CI], 1.18-1.41; UP/1 g increase: OR, 1.10; 95% CI, 1.03-1.17). In addition, nephrotic range proteinuria, but not moderate UP (UP: 1.5-3.49 g/day), was significantly correlated with hypothyroidism compared to UP < 0.5 g/day. In summary, decreased kidney function and nephrotic range proteinuria, not non-nephrotic proteinuria, are independently associated with the hypothyroidism.

DOI： 10.1038/s41598-022-19226-0

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