Modified Creatinine Index and the Risk of Bone Fracture in Patients Undergoing Hemodialysis: The Q-Cohort Study.

Background: Hemodialysis patients are at increased risk for bone fracture and sarcopenia. There is close interplay between skeletal muscle and bone. However, it is still unclear whether lower skeletal muscle mass increases the risk for bone fracture.

Association Between Serum Phosphate Levels and Stroke Risk in Patients Undergoing Hemodialysis: The Q-Cohort Study.

Background And Purpose: The contribution of serum phosphate levels to stroke risk in dialysis patients remains unclear. The present study aimed to elucidate the respective association between serum phosphate levels and the risk of brain hemorrhage or infarction in patients undergoing hemodialysis.

Methods: A total of 3437 patients undergoing hemodialysis were followed up for a median of 3.

The Fukuoka Kidney disease Registry (FKR) Study: design and methods.

Background: Chronic kidney disease (CKD) is an established independent risk factor for progression to end-stage renal disease (ESRD) and incidence of cardiovascular disease (CVD). The onset and progression of CKD are associated with both genetic predisposition and various lifestyle-related factors, but little is known about the influence of genetic-environmental interactions on the incidence of ESRD or CVD in patients with CKD.

Methods: The Fukuoka Kidney disease Registry (FKR) Study is designed as one of the largest prospective, multicenter, observational cohort studies in non-dialysis dependent CKD patients.

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L.

Selection of a lower dialysate calcium concentration (DCa) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa can worsen mineral and bone disorders. This 1-year retrospective observational study evaluated 121 hemodialysis patients at Fukuoka Renal Clinic who underwent conversion of DCa from 3.

Two Years of Cinacalcet Hydrochloride Treatment Decreased Parathyroid Gland Volume and Serum Parathyroid Hormone Level in Hemodialysis Patients With Advanced Secondary Hyperparathyroidism.

The long-term effect of cinacalcet hydrochloride treatment on parathyroid gland (PTG) volume has been scarcely investigated in patients with moderate to advanced secondary hyperparathyroidism (SHPT). The present study was a prospective observational study to determine the effect of cinacalcet treatment on PTG volume and serum biochemical parameters in 60 patients with renal SHPT, already treated with intravenous vitamin D receptor activator (VDRA). Measurement of biochemical parameters and PTG volumes were performed periodically, which were analyzed by stratification into tertiles across the baseline parathyroid hormone (PTH) level or PTG volume.

Dietary patterns and clinical outcomes in hemodialysis patients in Japan: a cohort study.

Background & Objectives: Little is known about actual dietary patterns and their associations with clinical outcomes in hemodialysis patients. We identified dietary patterns in hemodialysis patients in Japan and examined associations between dietary patterns and clinical outcomes.

Design, Setting, Participants, Measurements: We used data from 3,080 general-population participants in the Hisayama study (year 2007), and data from 1,355 hemodialysis patients in the Japan Dialysis Outcomes and Practice Patterns Study (JDOPPS: years 2005-2007).

Hyporesponsiveness to erythropoiesis-stimulating agent as a prognostic factor in Japanese hemodialysis patients: the Q-Cohort study.

Background: Previous epidemiological evidence has suggested that responsiveness to erythropoiesis-stimulating agents (ESAs) is related to prognosis in hemodialysis (HD) patients. We investigated the effects of hyporesponsiveness to ESA on mortality and cardiovascular events in Japanese HD patients, taking modifying factors into account.

Methods: A total of 2,905 Japanese HD patients aged ≥18 years who received ESA treatment were prospectively followed up for 4 years.

Heterochronic spontaneous rupture of bilateral renal cell carcinomas in a hemodialysis patient.

A 64-year-old man undergoing chronic hemodialysis was admitted under a shock state with macrohematuria and fatigue lasting for two hours. A blood analysis revealed severe anemia. Computed tomography disclosed a large right-sided perirenal hematoma.

Kienböck's disease: unusual cause of acute onset wrist pain in a dialysis patient.

Kienböck's disease is a rare disorder that presents with wrist pain and limitation of motion and is caused by avascular necrosis of the lunate bone. Dialysis patients occasionally present with wrist pain. However, Kienböck's disease is rarely reported in dialysis patients.

Does cinacalcet improve the prognosis of dialysis patients?

Appropriate control of serum calcium (Ca) and inorganic phosphate (Pi) levels is required for better prognosis of dialysis patients. Cinacalcet is known to reduce not only serum parathyroid hormone (PTH) but also Ca and Pi levels; however, it remains unclear whether cinacalcet can ultimately improve the prognosis of such patients. In this paper, the ongoing prospective observational study (Q Cohort Study) and double-blind randomized controlled study (EVOLVE Study) are introduced.

Health-related quality of life of predialysis patients with chronic renal failure.

Background: Health-related quality of life (HQOL) of predialysis patients with chronic renal failure (CRF) has received less attention than that of dialysis patients. We investigated changes in SF-36 over 1 year and examined associations between clinical parameters and SF-36 in predialysis CRF patients.

Methods: Subjects were 471 predialysis CRF patients.

Expression of synaptopodin and GLEPP1 as markers of steroid responsiveness in primary focal segmental glomerulosclerosis.

The crucial involvement of podocyte failure in the development of hereditary focal segmental glomerulosclerosis (FSGS) indicates that specific podocyte proteins are closely related to podocyte function and biology. We hypothesized that podocyte failure, reflected by alteration of these proteins, leads not only to FSGS but also to resistance to steroid therapy. We investigated the association between expression of synaptopodin and glomerular epithelial protein 1 (GLEPP1) and response to corticosteroid therapy in primary FSGS.

Stroke in patients on maintenance hemodialysis: a 22-year single-center study.

Background: Few studies have reported the detailed clinical features of stroke in patients with end-stage renal disease. We examined the frequency of the subtypes, mechanism, and outcome of stroke in patients receiving hemodialysis (HD).

Methods: We studied 151 consecutive patients who developed an acute stroke among the maintenance HD population in our kidney center during 22 years, divided into the initial 17-year (n = 61) and the more recent 5-year (n = 90) groups.

Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients: a 3-year prospective study.

Background/aim: Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD.

Methods: By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area).

Controlled, prospective trial of steroid treatment in IgA nephropathy: a limitation of low-dose prednisolone therapy.

Background: No accepted therapy has been established for progressive immunoglobulin A (IgA) nephropathy.

Methods: A prospective, randomized, controlled trial of low-dose prednisolone therapy was performed in patients with IgA nephropathy with moderate histological characteristics. Forty-three patients in the steroid group and 47 patients in the control group were included in the study.

Steroid responsiveness and frequency of relapse in adult-onset minimal change nephrotic syndrome.

To clarify factors influencing the response to corticosteroids and subsequent relapses, 62 Japanese adult patients with minimal change nephrotic syndrome were analyzed retrospectively. Five patients experienced remission spontaneously. Fifty-three patients entered complete remission, 3 patients entered partial remission, and 1 patient showed no response to corticosteroids.