Publications by authors named "Eiji Kusano"
A 76-year-old woman with type 2 diabetes mellitus was admitted to our hospital with a complaint of involuntary movements of the limbs and face. Brain MRI demonstrated a bilateral high signal of putamen on the T1 weighted image, and she was diagnosed with diabetic chorea. She took a second dose of the COVID-19 vaccine 28 days before admission and lost her appetite.
View Article and Find Full Text PDFAim: The incidence of cardiovascular and renal events was investigated in patients with type 2 diabetes who were classified according to anemia and the components of dialysis-independent chronic kidney disease (CKD) in a prospective observational study.
Methods: A population of 778 Japanese patients with type 2 diabetes was prospectively analyzed for 4 years. The outcomes were the incidence of cardiovascular events and renal events.
A Japanese man experienced three episodes of hypovolemic shock and was diagnosed with systemic capillary leak syndrome (SCLS). He developed SCLS exacerbation 2 days after receiving a second dose of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine, 1 year after the third episode. After fluid therapy and albumin administration, we initiated terbutaline and theophylline prophylaxis for SCLS.
View Article and Find Full Text PDFBackground: This study investigated the sex differences in the risk of end-stage kidney disease (ESKD) and mortality, as well as the effect modification of sex on associated factors in patients with type 2 diabetes.
Methods: This multicenter observational cohort study included 4328 patients with type 2 diabetes. Hazard ratios (HRs) with 95% confidence intervals (CIs) of sex for ESKD and death were estimated using Cox proportional regression with adjustment for baseline covariates.
Objective Diabetes is recognized as an underlying disease of constipation. However, the prevalence of constipation varies according to the diagnostic criteria applied. We investigated the prevalence of constipation based on the new guideline for constipation in Japanese patients with type 2 diabetes and examined the relationship with the clinical background, including diabetic vascular complications.
View Article and Find Full Text PDFArticle Synopsis
- The study evaluated how effective dulaglutide is for managing type 2 diabetes, taking into account different treatment backgrounds before starting dulaglutide.
- 89 patients were categorized into three groups based on their prior treatments: additional therapy, switching from DPP-4 inhibitors, and switching from daily GLP-1 receptor agonists.
- Results showed that HbA1c levels significantly decreased in all groups, with improved medication adherence noted among those who previously took daily GLP-1 RAs, suggesting that dulaglutide is effective regardless of previous treatments.
Article Synopsis
- * 96 patients were divided into two groups: one group received nutritional education at every visit while the other only once a year. After 2 years, 87 patients were analyzed for various health metrics.
- * Results showed the more educated group had lower body mass index, salt intake, and insulin use, indicating that frequent nutritional education may help reduce risks associated with diabetic kidney disease.
Article Synopsis
- Changes in albuminuria and estimated glomerular filtration rate (eGFR) can predict the risk of end-stage kidney disease (ESKD) in individuals with type 2 diabetes.
- A study involving 1417 patients found that significant drops in albumin levels correlated with a lower risk of ESKD, while significant rises posed a higher risk.
- The highest risk of ESKD was identified in patients showing both an increase in albumin and a decline in eGFR over two years, indicating that monitoring both factors together provides better risk assessment.
Aims: The safety and efficacy, particularly, the factors associated with the renal prognosis, were assessed over 12 months after the initiation of luseogliflozin therapy in Japanese patients with type 2 diabetes and renal impairment.
Methods: In total, 238 patients treated with luseogliflozin (2.5 mg, once daily) were studied as the safety analysis set.
Article Synopsis
- A study was conducted on 675 Japanese patients with type 2 diabetes to evaluate their renal and cardiovascular health over 4 years, specifically focusing on those with reduced eGFR without albuminuria.
- Results showed unchanged eGFR levels in non-albuminuric patients, whereas those with albuminuria experienced a decline, and cardiovascular events occurred more frequently in patients with albuminuria.
- The findings emphasize that while non-albuminuric patients with reduced eGFR are at lower risk for kidney disease, they still face significant cardiovascular risks that should be monitored.
Article Synopsis
- * Methylglyoxal (MGO) in PD fluids contributes significantly to this oxidative stress, leading to excessive growth of certain cells and accumulation of harmful compounds called advanced glycation end-products (AGEs) in a study on rats.
- * The study found that MGO treatment increased oxidative stress markers and altered the expression of genes responsible for metabolism in the peritoneum, indicating a potential mechanism for its damaging effects during PD.
Purpose: The factors associated with the renal prognosis over six months after the initiation of empagliflozin were compared between the non-elderly and elderly Japanese patients with type 2 diabetes.
Patients And Methods: In total, 132 patients treated with empagliflozin (10 mg, once daily) were studied as the safety analysis set. One hundred ten subjects whose medications were not changed during the observation period were investigated as the full analysis set to assess the effectiveness.
Article Synopsis
- The study aimed to assess how switching from daily DPP-4 inhibitors to weekly trelagliptin affects patient satisfaction, medication adherence, and unused medication in type 2 diabetes patients.
- A total of 79 patients participated after excluding those who didn't want to switch; their satisfaction and adherence were measured at baseline and 3 months post-switch.
- Results showed no change in HbA1c levels, but significant improvements in treatment satisfaction, perception of medication, adherence, and a reduction in unused drugs after the switch.
Article Synopsis
- The study investigated the effects of fingolimod (FTY720), an S1PR modulator, on salt-induced kidney damage in rats, comparing groups treated with or without DOCA.
- The DOCA+FTY720 group experienced significantly worse outcomes, including reduced survival, severe hypertension, and kidney cell injury, unlike the control group.
- Results indicate that FTY720 may exacerbate kidney issues in the presence of salt and DOCA, suggesting caution when prescribing this medication.
Article Synopsis
- Declines in estimated glomerular filtration rate (eGFR) of 20%, 30%, or 40% can indicate a risk for end-stage renal disease (ESRD) in patients with type 2 diabetes, as shown in a study with Japanese participants.
- The study involved 1868 patients followed for 2 years and 2001 patients for 3 years, finding that a notable percentage experienced declines in eGFR and ultimately developed ESRD.
- Strong correlations were observed between the magnitude of eGFR decline and the subsequent risk of ESRD, suggesting that even a 20% decline may serve as a potential warning sign for diabetic kidney disease.
Article Synopsis
- Acquired von Willebrand syndrome (AVWS) is a rare bleeding disorder that may go unnoticed in some patients until a significant event like trauma or surgery occurs.
- A case study of a 73-year-old man with nephrotic syndrome revealed AVWS after he experienced persistent bleeding post-renal biopsy, highlighting the importance of recognizing atypical clotting profiles.
- The report emphasizes the challenges in diagnosing AVWS and suggests that better awareness and documentation of similar cases can improve management and assessment of bleeding risks in patients.
Article Synopsis
- - Peritoneal dialysis is commonly used to treat end-stage kidney disease, but can face interruptions due to surgeries for other health issues.
- - A case study describes a 40-year-old woman whose dialysis was temporarily halted due to pleuroperitoneal communication and ovarian cancer, both of which were addressed through surgery.
- - The article highlights ongoing concerns in nephrology about managing dialysis during the recovery period, specifically regarding care for the dialysis catheter and the duration of necessary interruptions.
Article Synopsis
- * This study involved 90 ESRD patients on hemodialysis, divided into low- and high-FGF21 groups, and tracked mortality and cardiovascular events over roughly 64 months.
- * Results showed that high FGF21 levels correlated with a significantly higher mortality rate (28.3% vs. 9.1%), but did not affect the rate of cardiovascular events, indicating that FGF21 could be a useful marker for predicting mortality in ESRD patients.
Calciphylaxis is rare cutaneous manifestation associated with painful skin ulceration and necrosis. It primarily occurs in patients with end-stage chronic kidney disease. In this report, we would like to show our experience with a male patient presenting with minimal change nephrotic syndrome that was sequentially complicated by acute kidney injury and painful ulcerative cutaneous lesions due to calciphylaxis.
View Article and Find Full Text PDFArticle Synopsis
- * A 76-year-old patient with nephrotic syndrome developed acute PE and intracranial bleeding from a head injury, leading to a decision to treat the PE with intravenous heparin followed by warfarin.
- * Despite initial concerns about increased bleeding, the patient recovered well with no long-term neurological issues, highlighting important considerations about anticoagulation in similar cases.
Article Synopsis
- A 63-year-old immunocompromised man developed a laryngeal mass due to viral infections, resulting in a life-threatening airway blockage requiring urgent intubation and mechanical ventilation.
- Initial treatment with acyclovir for herpes zoster was changed to ganciclovir after finding a concurrent cytomegalovirus infection.
- The patient's condition improved, and he was taken off the ventilator after 10 days, with imaging showing no signs of the mass, suggesting the combined viral infections likely contributed to the mass formation.
Article Synopsis
- Abdominal hernias are a common cause of bowel obstructions and can be classified into external (abdominal wall) hernias and internal hernias, which involve protrusion through the peritoneum or mesentery.
- The case presented involves a female patient on peritoneal dialysis who experienced bowel obstruction caused by an internal hernia linked to a defect in the broad ligament of the uterus.
- Initially misdiagnosed, the patient underwent an exploratory laparotomy to correct the herniation, and the case highlights challenges related to perioperative management and diagnostic difficulties associated with this condition.
Article Synopsis
- Recent findings show that lifestyle changes are crucial in managing chronic kidney disease (CKD), highlighting the need for effective collaboration between general physicians and nephrologists in treatment.
- This study involved 2,379 CKD patients in Japan, comparing standard and advanced interventions that included educational support and better communication among healthcare providers.
- Results indicated that patients receiving the advanced intervention had lower rates of discontinuing medical follow-up and higher collaboration between their GPs and nephrologists, along with a trend towards improved kidney function stability.
Article Synopsis
- The study aimed to explore how effective certain biomarkers in peritoneal effluent can indicate deterioration in the peritoneum and functional decline in patients undergoing peritoneal dialysis.
- Researchers analyzed samples from 218 patients over eight years, measuring levels of MMP-2, IL-6, hyaluronan, and CA125 to assess their correlation with peritoneal deterioration.
- Findings revealed that MMP-2 was the most significant predictor of peritoneal solute transport rate, suggesting it could be used as a reliable indicator for monitoring patient health in peritoneal dialysis.
Article Synopsis
- The study investigates peritoneal deterioration, a significant issue linked to structural and functional problems in peritoneal dialysis (PD), by examining biomarkers in the effluent.* -
- In an animal experiment, rats treated with methylglyoxal (MGO) showed elevated levels of tenascin-C (TN-C) and excessive proliferation of TN-C-positive mesothelial cells, indicative of changes in cell behavior, in contrast to the rats treated with formaldehyde (FA).* -
- Clinical data from 182 PD patients revealed a strong correlation between peritoneal function (measured via the peritoneal equilibration test) and the levels of TN-C and matrix metalloproteinase-2 (MMP-