Publications by authors named "Saka Y"

Article Synopsis
  • Blood pressure management is crucial for patients with chronic kidney disease (CKD), and recent studies highlight that many still struggle with this, even with medication.
  • The study analyzed the effects of sacubitril/valsartan (ARNI) on proteinuria and blood pressure in stage 4-5 CKD patients, revealing a significant reduction in protein levels and systolic blood pressure after using ARNI for six months.
  • The findings suggest that ARNI may be beneficial for reducing proteinuria in advanced CKD, especially in patients who have uncontrolled hypertension.
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Background: The characteristics of patients with advanced chronic kidney disease (CKD) who are recipients of public assistance in Japan, and the adequacy of their medical care have not been reported previously.

Methods: The records of patients with CKD stage G5 who visited nine facilities in Japan from April to June 2013 were retrospectively reviewed to compare the characteristics and care of recipients of public assistance with those of non-recipients. Receiving a presentation of kidney replacement therapy (KRT) options and polypharmacy were used as indicators of suboptimal medical care.

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Introduction: The aim of the study was to explore the association between urate-lowering agents and reduced response to erythropoietin-stimulating agents in patients suffering from chronic kidney disease G5.

Methods: We conducted a cross-sectional, multicenter study in Japan between April and June 2013, enrolling patients aged 20 years or older with an estimated glomerular filtration rate of ≤15 mL/min/1.73 m2.

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Article Synopsis
  • Infection is a leading cause of death in chronic kidney disease (CKD) patients, and proton pump inhibitors (PPIs), commonly prescribed to them, may increase the risk of infections.
  • A study analyzing 485 CKD patients on hemodialysis found that those using PPIs had a significantly higher rate of infection events compared to those not using them (29.9% vs. 13.0%).
  • Even after adjusting for variables, PPI users still showed a higher incidence of infections (28.8% vs. 12.1%), indicating a strong association between long-term PPI use and infection risks in this demographic.
  • The findings suggest that clinicians should carefully consider the duration of PPI therapy to mitigate infection risks
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Background: More than 40 million people live in onchocerciasis-endemic areas in Nigeria. For at least 19 y, mass drug administration (MDA) with ivermectin was implemented with at least 65% total population coverage in Kaduna, Kebbi and Zamfara states. Impact surveys done using skin biopsies yielded no infections.

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Background: Prognosis of nephrotic syndrome has been evaluated based on pathological diagnosis, whereas its clinical course is monitored using objective items and the treatment strategy is largely the same. We examined whether the entire natural history of nephrotic syndrome could be evaluated using objective common clinical items.

Methods: Machine learning clustering was performed on 205 cases from the Japan Nephrotic Syndrome Cohort Study, whose clinical parameters, serum creatinine, serum albumin, dipstick hematuria, and proteinuria were traceable after kidney biopsy at 5 measured points up to 2 years.

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Background: Integrated transmission assessment surveys (iTAS) have been recommended for evaluation of the transmission of both lymphatic filariasis (LF) and onchocerciasis as the prevalence of both diseases moves toward their respective elimination targets in Nigeria. Therefore, we conducted an iTAS between May and December 2017 in five local government areas (LGAs), also known as implementation units (IUs), in states of Cross River, Taraba and Yobe in Nigeria.

Methods: The TAS comprised two phases: the Pre-iTAS and the iTAS itself.

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Article Synopsis
  • Previous studies on serum albumin concentration's effect on proteinuria remission in minimal change disease (MCD) showed mixed results, prompting this study to investigate its impact in a large cohort of 108 adult patients in Japan.
  • The study found that 96.3% of patients achieved remission of proteinuria, with lower serum albumin levels and higher estimated glomerular filtration rate (eGFR) linked to earlier remission.
  • However, serum albumin levels were not associated with the relapse of proteinuria, indicating that while albumin concentration plays a role in remission timing, it doesn't affect the likelihood of relapse in MCD.
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Introduction: Immunoglobulin A (IgA) nephropathy is a disease that presents with urinary symptoms such as glomerular hematuria and urinary protein positivity, with predominant deposition of IgA in the mesangial region of the glomerulus. Corticosteroids are mainly used for treatment; however, infection is a serious adverse event, and evidence regarding therapeutic efficacy is insufficient, thus new treatments are strongly desired. Mesenchymal stem cells (MSCs) contribute to the amelioration of inflammation and recovery of organ function in inflammatory environments by converting the character of leukocytes from inflammatory to anti-inflammatory and inducing the proliferation and differentiation of organ component cells, respectively.

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Ceftriaxone is a third-generation cephalosporin commonly used to treat infection. However, encephalopathy is an emerging adverse effect of ceftriaxone infusion. These patients present with various symptoms, including those of neurotoxicity, that typically resolve 1 week after discontinuation of ceftriaxone.

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Background: Minimal change disease (MCD) is characterized by a nephrotic syndrome usually steroid-sensitive and a high incidence of relapse of proteinuria. Previous cohort studies have reported conflicting results regarding the association between the time to remission and incidence of relapse.

Methods: This multicenter prospective cohort study included 102 adult patients with steroid-sensitive MCD or focal segmental glomerulosclerosis from a 5-year cohort study of primary nephrotic syndrome, the Japan Nephrotic Syndrome Cohort Study, who achieved remission of proteinuria within 2 months of immunosuppressive therapy (IST).

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Objective: Zinc (Zn) plays an important role in immune function. Several studies have identified an association between a Zn deficiency and infection. Infectious diseases are major complications of chronic kidney disease (CKD).

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Although drug-eluting stents have improved clinical outcomes, percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) remains a challenging procedure in terms of thrombus management. A new-generation P2Y12 receptor inhibitor, prasugrel, provides more rapid and potent antiplatelet action compared with clopidogrel. Prasugrel achieved significant reduction of ischemic events compared with clopidogrel in ACS.

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Background: Sodium zirconium cyclosilicate (SZC) is an oral potassium binder approved to treat hyperkalemia in adults in a number of countries, including Japan.

Methods: This phase 2/3, randomized, double-blind, placebo-controlled, dose-response study (ClinicalTrials.gov: NCT03127644) was designed to determine the efficacy and safety of SZC in Japanese adults with hyperkalemia.

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Background: The aim of the present study was to clarify the prevalence of immunosuppressive drug use and outcomes in elderly and non-elderly patients with primary membranous nephropathy (MN) in nationwide real-world practice in Japan.

Patients And Methods: Between 2009 and 2010, 374 patients with primary nephrotic syndrome were enrolled in the cohort study (The Japan Nephrotic Syndrome Cohort Study, JNSCS), including 126 adult patients with MN. Their clinical characteristics were compared with those of nephrotic patients with primary MN registered in a large nationwide registry (The Japan Renal Biopsy Registry, J-RBR).

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Following the halt of mass drug administration (MDA) for lymphatic filariasis (LF), the WHO recommends at least 4 years of post-treatment surveillance (PTS) to confirm that transmission recrudescence or importation does not occur. The primary means of evaluation during PTS is repeated transmission assessment surveys (TASs) conducted at 2- to 3-year intervals after TAS-1 stop-MDA surveys. This study reports the results of TAS-2 and TAS-3 surveys in Plateau and Nasarawa states (pop.

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Background: Despite recent advances in immunosuppressive therapy for patients with primary nephrotic syndrome, its effectiveness and safety have not been fully studied in recent nationwide real-world clinical data in Japan.

Methods: A 5-year cohort study, the Japan Nephrotic Syndrome Cohort Study, enrolled 374 patients with primary nephrotic syndrome in 55 hospitals in Japan, including 155, 148, 38, and 33 patients with minimal change disease (MCD), membranous nephropathy (MN), focal segmental glomerulosclerosis (FSGS), and other glomerulonephritides, respectively. The incidence rates of remission and relapse of proteinuria, 50% and 100% increases in serum creatinine, end-stage kidney disease (ESKD), all-cause mortality, and other major adverse outcomes were compared among glomerulonephritides using the Log-rank test.

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Plateau and Nasarawa states in central Nigeria were endemic for onchocerciasis. The rural populations of these two states received annual ivermectin mass drug administration (MDA) for a period of 8-26 years (1992-2017). Ivermectin combined with albendazole was given for 8-13 of these years for lymphatic filariasis (LF); the LF MDA program successfully concluded in 2012, but ivermectin MDA continued in areas known to have a baseline meso-/hyperendemic onchocerciasis.

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Background: Fractional flow reserve (FFR) measurement is the gold standard for identifying the functional severity of coronary artery disease. Although we can use newly developed pressure wires with optical fibers are now available, their safety and accuracy for FFR measurement are not clear. Therefore, we planned a clinical comparison study between pressure wires with optical fibers and the conventional FFR device.

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Article Synopsis
  • Thiamine deficiency is common in patients with chronic kidney disease (CKD), particularly those at the end stage, due to factors like malnutrition and long-term diuretic use.
  • A study involving 288 dialysis patients analyzed their thiamine levels, finding that around 12.4% had critically low thiamine concentrations, with scores indicating physical function being significant indicators.
  • Low physical function, measured by the Barthel index, was identified as an independent risk factor for thiamine deficiency, highlighting the need for clinicians to monitor thiamine levels in end-stage CKD patients, especially those with decreased physical ability.
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