Faculty Profiles - Onishi Yasuhiro

Papers - Onishi Yasuhiro

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Case series showing the safety and changes in lipid profiles of hemodialysis patients with hypertriglyceridemia after pemafibrate administration Reviewed

Rino Okada, Yasuhiro Onishi, Naoya Kobayashi, Hiroyuki Ishihara, Tomohisa Yokoyama, Tomoyo Mifune, Yoshimasa Sakurabu, Ichiro Nojima, Hiroshi Morinaga, Haruhito A. Uchida, Jun Wada

Renal Replacement Therapy 2024.12

A case of renal hypouricemia due to T217M mutation in SLC22A12 incidentally associated with IgA nephropathy. International journal

Yoshimasa Sakurabu, Haruhito A Uchida, Toshihisa Tahara, Tomohiko Asakawa, Haruka Yamasaki, Katsuyoshi Katayama, Shugo Okamoto, Yasuhiro Onishi, Natsumi Matsuoka-Uchiyama, Keiko Tanaka, Hidemi Takeuchi, Kenji Tsuji, Ryoko Umebayashi, Yuki Ohashi, Kimiyoshi Ichida, Jun Wada

Clinical case reports 12 ( 9 ) e9368 2024.9

Language：English Publishing type：Research paper (scientific journal)

A T217M heterozygous mutation in the SLC22A12 gene caused renal hypouricemia; this patient with IgA nephropathy had no findings other than IgA nephropathy on renal biopsy. Hypouricemia was susceptible to oxidative stress, but IgA nephropathy in the patient with hypouricemia could be treated with steroid pulse therapy without adverse events.

DOI： 10.1002/ccr3.9368

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術前栄養状態と骨格筋評価が腎移植レシピエントの腎予後に与える影響

山野井友昭, 西村慎吾, 関戸崇了, 吉永香澄, 定平卓也, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 大西康博, 竹内英実, 田邊克幸, 森永裕士, 荒木元朗

移植 59 ( 総会臨時 ) 323 - 323 2024.9

Pregnancy and childbirth in Takayasu arteritis in Japan: A nationwide retrospective study.

Takako Miyamae, Manabe Y, Sugihara T, Umezawa N, Yoshifuji H, Tamura N, Abe Y, Furuta S, Nagafuchi H, Ishizaki J, Nakano N, Atsumi T, Karino K, Amano K, Kurasawa T, Ito S, Yoshimi R, Ogawa N, Banno S, Naniwa T, Ito S, Hara A, Hirahara S, Uchida HA, Onishi Y, Murakawa Y, Komagata Y, Nakaoka Y, Harigai M

Modern rheumatology 2024.8

Publishing type：Research paper (scientific journal)

<h4>Objectives</h4>This study aimed to understand the status quo of medical treatments of the primary disease and pregnancy outcomes in patients with Takayasu arteritis (TAK) and children's birth outcomes.<h4>Methods</h4>This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labor, and Welfare for Intractable Vasculitis.<h4>Results</h4>This study enrolled 51 cases and 68 pregnancies 2019-2021. Of these, 48 cases and 65 pregnancies (95.6%) resulted in delivery and live-born babies. The median age of diagnosis and delivery was 22 and 31, respectively. Preconception therapy included prednisolone (PSL) in 51 (78.5%, median 7.5 mg/day), immunosuppressants in 18 (27.7%), and biologics in 12 (18.5%) pregnancies. Six cases underwent surgical treatment before pregnancy. Medications during pregnancy included PSL in 48 (73.8%, median: 9 mg/day), immunosuppressants in 13 (20.0%), and biologics in 9 (13.8%) pregnancies. Enlargement of an aneurysm was reported in one pregnancy, which might be associated with increased circulating plasma volume. TAK relapsed in 4 (6.2%) and 8 (12.3%) pregnancies during pregnancy and after delivery, respectively. Additionally, 13/62 (20.9%) preterm infants and 17/59 (28.8%) low birth weight infants were observed, and none had serious postnatal abnormalities. Of the 51 confirmed infants, 42 (82.4%) were exclusively breastfed or mixed with formula.<h4>Conclusion</h4>Most pregnancies in TAK were manageable with PSL at ≤10 mg/day. Relapse during pregnancy and postpartum occurred in <20% of pregnancies.

DOI： 10.1093/mr/roae068

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岡山市CKDネットワーク(OCKD-NET)2の登録2年後のデータ解析

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 66 ( 4 ) 677 - 677 2024.6

医学生教育における腎生検シミュレーターを用いた腎生検実習の意義

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

日本腎臓学会誌 66 ( 4 ) 597 - 597 2024.6

Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3). International journal

Asami Ueno, Yasuhiro Onishi, Koki Mise, Satoshi Yamaguchi, Ayaka Kanno, Ichiro Nojima, Chigusa Higuchi, Haruhito A Uchida, Kenichi Shikata, Satoshi Miyamoto, Atsuko Nakatsuka, Jun Eguchi, Kazuyuki Hida, Akihiro Katayama, Mayu Watanabe, Tatsuaki Nakato, Atsuhito Tone, Sanae Teshigawara, Takashi Matsuoka, Shinji Kamei, Kazutoshi Murakami, Ikki Shimizu, Katsuhito Miyashita, Shinichiro Ando, Tomokazu Nunoue, Jun Wada

BMJ open diabetes research & care 12 ( 3 ) 2024.5

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: ACE cleaves angiotensin I (Ang I) to angiotensin II (Ang II) inducing vasoconstriction via Ang II type 1 (AT1) receptor, while ACE2 cleaves Ang II to Ang (1-7) causing vasodilatation by acting on the Mas receptor. In diabetic kidney disease (DKD), it is still unclear whether plasma or urine ACE2 levels predict renal outcomes or not. RESEARCH DESIGN AND METHODS: Among 777 participants with diabetes enrolled in the Urinary biomarker for Continuous And Rapid progression of diabetic nEphropathy study, the 296 patients followed up for 9 years were investigated. Plasma and urinary ACE2 levels were measured by the ELISA. The primary end point was a composite of a decrease of estimated glomerular filtration rate (eGFR) by at least 30% from baseline or initiation of hemodialysis or peritoneal dialysis. The secondary end points were a 30% increase or a 30% decrease in albumin-to-creatinine ratio from baseline to 1 year. RESULTS: The cumulative incidence of the renal composite outcome was significantly higher in group 1 with lowest tertile of plasma ACE2 (p=0.040). Group 2 with middle and highest tertile was associated with better renal outcomes in the crude Cox regression model adjusted by age and sex (HR 0.56, 95% CI 0.31 to 0.99, p=0.047). Plasma ACE2 levels demonstrated a significant association with 30% decrease in ACR (OR 1.46, 95% CI 1.044 to 2.035, p=0.027) after adjusting for age, sex, systolic blood pressure, hemoglobin A1c, and eGFR. CONCLUSIONS: Higher baseline plasma ACE2 levels in DKD were protective for development and progression of albuminuria and associated with fewer renal end points, suggesting plasma ACE2 may be used as a prognosis marker of DKD. TRIAL REGISTRATION NUMBER: UMIN000011525.

DOI： 10.1136/bmjdrc-2024-004237

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【肥満と健康障害】肥満関連腎臓病

大西康博, 和田淳

臨床検査 68 ( 5 ) 637 - 643 2024.5

Successful treatment for life threatening recurrent non-traumatic rectus sheath hematoma in a case with microscopic polyangiitis with rapidly progressive glomerulonephritis.

Hiroyuki Nakanoh, Hidemi Takeuchi, Morimoto Shiho, Yuya Terajima, Shugo Okamoto, Yasuhiro Onishi, Keiko Tanaka, Takayuki Katsuyama, Kenji Tsuji, Yoshinori Matsumoto, Katsuyuki Tanabe, Hiroshi Morinaga, Mayu Uka, Koji Tomita, Haruhito A Uchida, Takao Hiraki, Jun Wada

Internal medicine (Tokyo, Japan) 2024.4

Language：English Publishing type：Research paper (scientific journal)

A 68-year-old woman was admitted to our hospital because of a rapid progression of renal dysfunction with positive myeloperoxidase antineutrophil cytoplasmic antibody and was diagnosed with rapidly progressive glomerulonephritis associated with microscopic polyangiitis (MPA). Severe right rectus sheath hematoma (RSH) bleeding from the inferior epigastric artery developed after starting hemodialysis, which required 4 transarterial embolizations due to recurrent bleeding. After additional treatment with methylprednisolone pulse therapy and rituximab, no rebleeding occurred. Although the giant hematoma reached the pelvis, it shrank spontaneously without any intervention. Nontraumatic RSH should therefore be considered when treating patients with multiple risk factors.

DOI： 10.2169/internalmedicine.3239-23

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Inhibition of Amino Acids Influx into Proximal Tubular Cells Improves Lysosome Function in Diabetes

Kano, Y., Yamaguchi, S., Mise, K., Kawakita, C., Onishi, Y., Kurooka, N., Sugawara, R., Albuayjan, H.H.H., Nakatsuka, A., Eguchi, J., Wada, J.

Kidney360 5 ( 2 ) 2024.2

当院における生体腎移植ドナーの術後フォローアップ状況

山野井友昭, 西村慎吾, 関戸崇了, 吉永香澄, 丸山雄樹, 定平卓也, 別宮謙介, 枝村康平, 小林知子, 小林泰之, 大西康博, 竹内英実, 田邊克幸, 森永裕士, 荒木元朗

日本臨床腎移植学会プログラム・抄録集 57回 208 - 208 2024.2

当院における先行的生体腎移植の検討

吉永香澄, 関戸崇了, 丸山雄樹, 山野井友昭, 西村慎吾, 富永悠介, 定平卓也, 片山聡, 岩田健宏, 大西康博, 竹内英実, 田邊克幸, 森永裕士, 和田淳, 枝村康平, 小林知子, 小林泰之, 荒木元朗

日本臨床腎移植学会プログラム・抄録集 57回 210 - 210 2024.2

Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study. International journal

Kenji Tsuji, Hiroyuki Nakanoh, Kensaku Takahashi, Takafumi Morita, Yizhen Sang, Kazuhiko Fukushima, Natsumi Matsuoka-Uchiyama, Yasuhiro Onishi, Haruhito A Uchida, Shinji Kitamura, Jun Wada

Kidney medicine 5 ( 12 ) 100733 - 100733 2023.12

Language：English Publishing type：Research paper (scientific journal)

RATIONALE & OBJECTIVE: Assessment of kidney biopsies provides crucial information for diagnosis and disease activity, as well as prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system in the corticomedullary region. However, the role of VMC and the clinical significance of VMC variants are poorly understood. In the present study, we investigated kidney prognostic values of VMC variants. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Among 808 patients who underwent a kidney biopsy from 2011 to 2019, 246 patients whose kidney biopsy specimens contained VMC were enrolled. PREDICTORS: VMC variants; inflammatory-VMC (an infiltration of ≥80 inflammatory cells/mm2-VMC area) and VMC hypertrophy (hyper-VMC, a VMC average width ≥850 μm), and the interstitial fibrosis/tubular atrophy (IFTA) score. OUTCOMES: A decline in estimated glomerular filtration rate (eGFR) ≥40% from the baseline or commencement of kidney replacement therapy. ANALYTICAL APPROACH: Cox proportional hazards model. RESULTS: Among 246 patients with data on VMC, mean baseline eGFR was 56.0±25.6 ml/min per 1.73 m2; 80 had high inflammatory-VMC, and 62 had VMC hypertrophy. There were 51 kidney events over median follow-up of 2.5 years. We analyzed 2 VMC variants. Multivariable logistic regression analysis revealed that eGFR negatively correlated with the presence of both inflammatory-VMC and hyper-VMC. A Cox proportional hazards analysis revealed that inflammatory-VMC (but not hyper-VMC) was independently associated with the primary outcome after adjustments for known risk factors of progression, including proteinuria, eGFR, and the interstitial fibrosis/tubular atrophy (IFTA) score (hazard ratio, 1.97; 95% confidence interval, 1.00-3.91). LIMITATIONS: Single-center study and small sample size. CONCLUSIONS: Assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy. PLAIN-LANGUAGE SUMMARY: Assessment of kidney biopsies provides crucial information for diagnosis, disease activity, and prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system. Currently, the role of VMC in kidney health and diseases and the clinical significance of VMC variants are poorly understood. In the present study, we have shown that an infiltration of ≥80 inflammatory cells/mm2-VMC area (inflammatory-VMC) is independently associated with kidney disease progression after adjustments for known risk factors of progression. Therefore, assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy.

DOI： 10.1016/j.xkme.2023.100733

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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 2023.9