Publications by authors named "Akito Maeshima"

Excessive fructose intake causes a variety of adverse conditions (e.g., obesity, hepatic steatosis, insulin resistance and uric acid overproduction).

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Ceftriaxone is widely used clinically but it can potentially cause ceftriaxone encephalopathy in individuals who are on dialysis. We describe ceftriaxone encephalopathy in a dialysis patient. The 87-year-old Japanese woman had a 9-year dialysis history.

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Activins, multifunctional cytokines of the transforming growth factor-beta superfamily, play critical roles in the regulation of growth and differentiation in multiple biological systems. Activin activity is finely regulated by the endogenous antagonist follistatin. Early studies reported that activins are involved in renal organogenesis, but subsequent research demonstrated that activins also play a significant role in kidney regeneration following injury.

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Epidermal growth factor (EGF), an essential factor for the proliferation and survival of renal tubular cells, is expressed by distal tubules and normally excreted via urine. Previous studies in rats demonstrated that acute tubular injury reduces urinary EGF levels. However, it is unclear whether urinary EGF is a suitable monitoring marker of tubular repair status after acute kidney injury (AKI) in humans.

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Activin A is known to impede tubular repair following renal ischemia, whereas exogenous follistatin, an activin A antagonist, has been shown to ameliorate kidney damage in rats. Despite these findings, the precise role of endogenous follistatin in the kidney has yet to be elucidated. In this study, we investigated the localization of follistatin in the normal human kidney and its potential utility as a marker for acute kidney injury (AKI).

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Article Synopsis
  • Multicentric Castleman's disease (MCD) is a rare, benign condition characterized by abnormal growth of lymphoid tissue, affecting both lymph nodes and other organs; this case involves a 55-year-old man with significant kidney infiltration by IgG4+ plasma cells.* -
  • The patient exhibited symptoms like high fever and diarrhea, along with lab findings including renal dysfunction, anemia, and elevated IgG4 levels, alongside lymph node enlargement observed through CT scans.* -
  • Diagnosis of idiopathic MCD was confirmed through biopsies indicating plasma cell infiltration and other pathological features; treatment with tocilizumab led to sustained remission, highlighting the need for a careful diagnostic approach considering the disease's varied responses to treatment.*
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Autophagy is involved in the development of diabetic kidney disease (DKD), the leading cause of end-stage renal disease. The Fyn tyrosine kinase (Fyn) suppresses autophagy in the muscle. However, its role in kidney autophagic processes is unclear.

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Activin A, a member of the TGF-beta superfamily, is a negative regulator of tubular regeneration after renal ischemia. Activin action is controlled by an endogenous antagonist, follistatin. However, the role of follistatin in the kidney is not fully understood.

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Article Synopsis
  • Activin is a cytokine involved in regulating cell growth and differentiation, significantly increased in ischemic kidneys, suggesting it inhibits tubular repair after kidney injury.
  • In this study, researchers investigated the levels of activin A in patients with acute kidney injury (AKI) and found that urinary activin A was significantly elevated in AKI cases compared to healthy individuals.
  • The study indicates that urinary activin A levels correlate with the severity of AKI, potentially serving as a non-invasive biomarker to assess kidney injury severity.
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Introduction: Isolated ultrafiltration (IUF) is an alternative treatment for diuretic-resistant patients with fluid retention. Although hemodialysis (HD) predominantly decreases extracellular water (ECW), the impact of IUF on fluid distribution compared with HD remains unclear.

Methods: We compared the effect of HD (n = 22) and IUF (n = 10) sessions on the body fluid status using a bioimpedance analysis device (InBody S10).

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Background: Pregnancy is an important issue for many women with systemic lupus erythematosus (SLE). This study examined maternal and fetal outcomes among SLE women with or without a history of lupus nephritis (LN).

Methods: We retrospectively analyzed 98 pregnancies in 57 women previously diagnosed with SLE who gave birth at our hospital.

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We retrospectively compared the post-transplantation graft survival and the donor's estimated glomerular filtration rates (eGFRs) following living donor kidney transplantations (LDKTs) involving medically complex living donors (MCLDs) (the elderly and patients with obesity, hypertension, diabetes mellitus, or reduced renal function) and standard living donors (SLDs). The clinical data on patients who underwent LDKTs at our institution from 2006-2019, including 192 SLDs and 99 MCLDs, were evaluated. Regarding recipients, the log-rank test and multivariable Cox proportional hazards analyses showed a higher incidence of overall and death-censored graft loss in the recipients who received kidneys from MCLDs (Hazard ratio = 2.

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Article Synopsis
  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors like dapagliflozin not only help lower blood sugar but also have a mild diuretic effect, possibly affecting body fluid levels in patients with diabetic kidney disease (DKD).
  • In a study, 36 DKD patients treated with dapagliflozin showed significant reductions in body weight and different body fluid components, with more pronounced effects in those who initially had higher extracellular volume levels.
  • The results suggest that the initial extracellular volume status plays a crucial role in predicting how patients will respond to dapagliflozin, which could help in managing fluid balance during treatment.
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Tissue resident mononuclear phagocytes (Mophs), comprising monocytes, macrophages, and dendritic cells (DCs), play important roles under physiological and pathological conditions. The presence of these cells in the kidney has been known for decades, and studies of renal Mophs (rMophs) are currently underway. Since no unified procedure has been identified to isolate rMophs, results of flow cytometric analysis of rMophs have been inconsistent among studies.

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Activin A, a member of the transforming growth factor-beta superfamily, is a critical modulator of inflammation and plays a key role in controlling the cytokine cascade that drives the inflammatory response. However, the role of activin A in inflammatory kidney diseases remains unknown. To address this issue, we examined here whether activin A can be detected in the kidney and/or urine from patients with antineutrophil cytoplasmic antibody (ANCA) -associated vasculitis (AAV).

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The N-type Ca2+ channel (Cav2.2) is distributed in sympathetic nerves that innervate the tubules, the vessels, and the juxtaglomerular granular cells of the kidney. However, the role of N-type Ca2+ channels in renal disease remains unknown.

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The new type 2 diabetes drug, dapagliflozin, reduces blood glucose levels and body weight by inhibiting sodium glucose transporter 2 (SGLT2) in proximal tubular cells. SGLT2 inhibitors might modulate glucose influx into renal tubular cells, thereby regulating the metabolic conditions that cause endoplasmic reticulum (ER) stress in the cells. In this study, we examined the effect of dapagliflozin on ER stress in the HK-2 proximal tubular cell line and in the kidney of db/db mice to characterise its function in diabetic nephropathy (DN).

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  • Tolvaptan, a medication that blocks vasopressin V2 receptors, helps reduce body fluid retention in patients with chronic kidney disease (CKD) but its effectiveness predictors remain unclear.
  • In a study with 12 CKD patients treated with tolvaptan, significant reductions in body weight and total body water were noted, without major changes in kidney function (measured by eGFR).
  • Serum albumin levels were found to be a relevant predictor of how well patients respond to tolvaptan, suggesting that it could be especially beneficial for patients with low albumin levels.
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Renal impairment (RI) is a common complication of multiple myeloma (MM) that significantly affects treatment efficacy and mortality. However, no useful biomarkers for early detection of renal damage in MM exist. Reports indicate that activin A, a multifunctional cytokine of the TGF-β superfamily, is involved in the development and progression of various kidney diseases.

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Tubulogenesis, the organization of epithelial cells into tubular structures, is an essential step during renal organogenesis as well as during the regeneration process of renal tubules after injury. In the present study, endothelial cell-derived factors that modulate tubule formation were examined using an in vitro human tubulogenesis system. When human renal proximal tubular epithelial cells (RPTECs) were cultured in gels, tubular structures with lumens were induced in the presence of hepatocyte growth factor (HGF).

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  • * Treatment with furosemide reduced extracellular fluid more than intracellular fluid, while adding tolvaptan led to a more balanced reduction and better overall diuretic response.
  • * This case highlights for the first time how furosemide and tolvaptan affect fluid distribution differently in the same patient, with tolvaptan also increasing plasma colloid osmotic pressure.
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  • SGLT2 inhibitors like dapagliflozin (DAPA) are medications that help lower blood sugar levels and have diuretic effects, but their impact on fluid distribution compared to traditional diuretics is not well understood.
  • A study of 40 chronic kidney disease patients showed that all treatment groups (DAPA, furosemide, and tolvaptan) experienced significant weight loss and increased urine output over 7 days, with notable changes in extracellular water (ECW) levels.
  • DAPA led to a smaller reduction in ECW compared to furosemide, but a larger reduction than tolvaptan, indicating that SGLT2 inhibitors may affect fluid distribution differently than conventional diuretics.
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Hepatitis E is an acute self-limiting disease caused by hepatitis E virus (HEV). Recent reports show that HEV can induce chronic hepatitis or be reactivated in immunocompromised hosts. We report a 63-year-old woman with rheumatoid arthritis (RA) who developed hepatitis E during treatment with tocilizumab.

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Nivolumab is an anti-programmed cell death-1 (PD-1) antibody that is utilized as an immune checkpoint inhibitor (ICI) for cancer therapy. We herein present the case of a 57-year-old man who developed acute kidney injury during treatment with nivolumab for lung cancer. A renal biopsy revealed acute tubulointerstitial nephritis.

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