Effect of monoclonal gammopathy in the progression of acute kidney injury and chronic kidney disease: a retrospective observational study.

Background: The involvement of monoclonal immunoglobulin (MIg) in renal damage in patients with haematological disorders and renal biopsy-proven monoclonal gammopathy of renal significance is well established. However, no epidemiological studies have been conducted on the effects of MIg on renal function in other patients. We aimed to evaluate the renal prognosis of MIg-positive patients and the effects of MIg on renal function.

Effect of age, sex, and chronic kidney disease on urinary creatinine excretion in Japanese patients.

Background: Urinary creatinine levels are used to estimate the excretion rates of certain analytes from the respective analyte-to-creatinine ratios. We clarified the influence of age and sex on estimated daily urinary creatinine excretion (eUCrE) based on the urinary creatinine level and daily urine volume.

Methods: All inpatients aged ≥ 18 years who attended the Kochi Medical School Hospital with serum and urinary creatinine measurement results were enrolled.

Differences in characteristics and risk factors for acute kidney injury between elderly and very elderly patients: a retrospective review.

Background: Few epidemiologic studies on acute kidney injury (AKI) have focused on the older adult population. This study aimed to clarify the characteristics and risk factors for AKI in this population.

Methods: This retrospective observational study was performed with the clinical data of all outpatients and inpatients aged ≥ 65 years at the time of enrolment at Kochi Medical School Hospital between 1 January 1981 and 31 December 2021.

Effect of mild hyponatremia on in-hospital falls of elderly hospitalized patients: A retrospective, cohort study.

Objectives: This study investigated the association between hyponatremia and falls in elderly hospitalized patients, focusing on mild hyponatremia as a potential risk factor.

Materials And Methods: A retrospective analysis of 16,952 patients admitted to Kochi Medical School Hospital from 2012 to 2021 was performed. Serum sodium levels were categorized, and falls during a 30-day observation period were recorded.

Incidence of acute kidney injury and decreased estimated glomerular filtration rate according to the site of cancer.

Background: The epidemiology of renal impairment in patients with cancer remains unclear. We aimed to clarify associations between various cancer sites and renal impairment.

Methods: We reviewed data from 5674 patients aged ≥ 18 years receiving cancer treatment at a single hospital facility.

Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study.

Background: To investigate risk factors for orally administered 5-aminolevulinic acid (ALA)-induced hypotension for bladder cancer patients receiving photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT).

Methods: Patients were categorized into two groups intraoperatively: a hypotensive group (minimum systolic blood pressure (SBP) ≤80 mmHg) and a non-hypotensive group (minimum SBP > 80 mmHg). We examined differences between the hypotensive group and non-hypotensive groups to identify clinical risk of ALA-induced hypotension using multivariate logistic regression analysis and decision tree analysis.

Long-term continuous use of proton-pump inhibitors is associated with renal function decline in patients without acute kidney injury.

Background: Proton-pump inhibitors (PPIs) are widely used to treat gastroesophageal reflex disease, peptic ulcer disease, and stress ulcer prophylaxis. This study estimated the progress rate of renal dysfunction in patients taking PPIs in clinical settings and compared the results with those of patients taking histamine-2 receptor antagonists (H2RAs).

Methods: We retrospectively reviewed patients' data collected from Kochi Medical School Hospital's information system between 2001 and 2019.

Effects of transient acute kidney injury, persistent acute kidney injury and acute kidney disease on the long-term renal prognosis after an initial acute kidney injury event.

Aim: To clarify the effects of the duration of acute damage and/or loss of renal function following an acute kidney injury event on the renal prognosis after recovery.

Methods: We retrospectively reviewed data collected between 1995 and 2016 from the Kochi Medical School Hospital. Patients were stratified according to the time required for recovery with fluid therapy (expected to reflect the presence of renal dysfunction): ≤2 days after onset, transient injury group (n = 491); 3 to 7 days after onset, persistent injury group (n = 1076); and ≥ 8 days after onset, acute kidney disease group (n = 1046).

Identification of risk factors for post-induction hypotension in patients receiving 5-aminolevulinic acid: a single-center retrospective study.

Background: 5-Aminolevulinic acid (5-ALA) is useful as a photodynamic agent, but its use commonly leads to hypotension. Although avoiding a mean arterial pressure (MAP) < 60 mmHg is important, the incidence of MAP < 60 mmHg when using 5-ALA is unclear. Therefore, we conducted a retrospective study to assess the incidence of post-induction hypotension and identified risk factors of this phenomenon.

Influence of hyperuricemia treatment on postoperative acute kidney injury among hyperuricemia patients: a single-center retrospective database analysis.

Objective: Hyperuricemia has been reported to be associated with the development of postoperative acute kidney injury (pAKI). However, it remains underdetermined whether hyperuricemia treatment could decrease the potential risk of pAKI. Here, we investigated this hypothesis among hyperuricemia patients with previously normal renal function by performing a retrospective database analysis.

Transition from acute kidney injury to chronic kidney disease: a single-centre cohort study.

Background: The incidence of acute kidney injury (AKI) is increasing. AKI is currently recognised as an inducer of chronic kidney disease (CKD) and this is known as the 'AKI-CKD transition'. This study aimed to evaluate the rate of decline in estimated glomerular filtration rate (eGFR) associated with AKI events in individuals with and without pre-existing CKD.

Evaluation of the accuracy of estimated baseline serum creatinine for acute kidney injury diagnosis.

Background: Modern epidemiologic studies of acute kidney injury (AKI) have been facilitated by the increasing availability of electronic medical records. However, pre-morbid reference serum creatinine (SCr) data are often unavailable in such records. Investigators substitute estimated baseline SCr with the eGFR 75 approach, instead of using actually measured baseline SCr.

Effects of topiroxostat in hyperuricemic patients with chronic kidney disease.

Background: Hyperuricemia is associated with chronic kidney disease (CKD). Although topiroxostat, a novel, non-purine, selective xanthine oxidase inhibitor, has a strong effect against hyperuricemia, limited data are available on its renoprotective effect against CKD.

Methods: This study was conducted between October 2014 and May 2016.

Incidence of acute kidney injury among patients with chronic kidney disease: a single-center retrospective database analysis.

Background: Acute kidney injury (AKI) is a serious complication among hospitalized individuals and is closely associated with chronic kidney disease (CKD).

Methods: This retrospective cohort study evaluated the incidences of AKI according to CKD stage at Kochi Medical School hospital during 1981-2011. AKI was defined and staged according to the kidney disease improving global outcomes criteria, using serum creatinine levels.

Serum uric acid level as a risk factor for acute kidney injury in hospitalized patients: a retrospective database analysis using the integrated medical information system at Kochi Medical School hospital.

Background And Objectives: Recent studies have shown that both low and high levels of serum uric acid (SUA) before cardiovascular surgery are independent risk factors for postoperative acute kidney injury (AKI). However, these studies were limited by their small sample sizes. Here, we investigated the association between SUA levels and AKI by performing a retrospective database analysis of almost 30 years of data from 81,770 hospitalized patients.

A hierarchical Bayesian framework to infer the progression level to diabetes based on deficient clinical data.

The increase in lifestyle-related diseases such as heart disease, diabetes, and high blood pressure is a challenging problem that should be resolved. The physiological mechanisms of the human body have long been studied using mathematical models. In particular, to study glucose metabolism, several models that infer insulin sensitivity and β-cell function have been developed.

Heavy alcohol intake is a risk factor for esophageal squamous cell carcinoma among middle-aged men: A case-control and simulation study.

Despite the advances in surgical techniques and treatments, the prognosis of esophageal cancer remains poor, since the disease is usually diagnosed at an advanced stage. Therefore, prevention plays an important role in reducing mortality. Smoking and alcohol intake are modifiable habits and are important risk factors for esophageal cancer.

Effects of smoking on outcomes after acute atherothrombotic stroke in Japanese men.

Background: The effects of smoking on clinical outcomes following acute stroke remain controversial.

Methods: We evaluated the influence of smoking on 90-day outcomes after acute atherothrombotic stroke in 292 Japanese men extracted from the database of the Edaravone and Argatroban Stroke Therapy for Acute Ischemic Stroke randomized parallel-group trial that tested the safety and efficacy of edaravone and argatroban therapy in 814 patients in 2004-2008. Smokers were matched with non-smokers of the same age for identical age distribution in the smoker and non-smoker groups.

[Improving data warehouse environments for efficient analysis of long time-series data].

Medical records contain enormous amounts of data. It is important to extract useful evidence from such data and feedback to clinical medicine. Evidence-based medicine (EBM) was introduced in the 1990s and has been widely used for more than 20 years, however, hospital information system environments that take advantage of the ideas of EBM have not yet been established.

Prognostic significance of smoking in patients with acute ischemic stroke within 3 months of onset.

Background: Various factors that have been implicated in recovery after the acute phase of stroke have not been well evaluated.

Methods: To identify prognostic factors affecting outcomes at 90 days after stroke from the viewpoint of recovery patterns, we enrolled 660 patients from the Edaravone and Argatroban Stroke Therapy for Acute Ischemic Stroke study database. Fourteen groups of patients were identified based on an analysis of their recovery patterns according to changes in their National Institutes of Health Stroke Scale scores during the first 21 days.

The recommendations from the 2009 SiHIS working conference in Hiroshima--Issues on trustworthiness of health information and patient safety.

Held on 21st to 23rd November 2009 in Hiroshima, the SiHIS working conference aimed at finding solutions to approach to an idealistic society where (1) the individual can trust information with full understanding and responsibility, (2) the individual can allow the use of information backed by sound legitimated environment, (3) information can play its role for better healthcare and the improvement of medicine. The purpose of this paper is to propose recommendations from this working conference.

Robust time estimation reconciles views of the antiquity of placental mammals.

Background: Molecular studies have reported divergence times of modern placental orders long before the Cretaceous-Tertiary boundary and far older than paleontological data. However, this discrepancy may not be real, but rather appear because of the violation of implicit assumptions in the estimation procedures, such as non-gradual change of evolutionary rate and failure to correct for convergent evolution.

Methodology/principal Findings: New procedures for divergence-time estimation robust to abrupt changes in the rate of molecular evolution are described.

Core set approach to reduce uncertainty of gene trees.

Background: A genealogy based on gene sequences within a species plays an essential role in the estimation of the character, structure, and evolutionary history of that species. Because intraspecific sequences are more closely related than interspecific ones, detailed information on the evolutionary process may be available by determining all the node sequences of trees and provide insight into functional constraints and adaptations. However, strong evolutionary correlations on a few lineages make this determination difficult as a whole, and the maximum parsimony (MP) method frequently allows a number of topologies with a same total branching length.

Fold recognition of the human immunodeficiency virus type 1 V3 loop and flexibility of its crown structure during the course of adaptation to a host.

The third hypervariable (V3) region of the HIV-1 gp120 protein is responsible for many aspects of viral infectivity. The tertiary structure of the V3 loop seems to influence the coreceptor usage of the virus, which is an important determinant of HIV pathogenesis. Hence, the information about preferred conformations of the V3-loop region and its flexibility could be a crucial tool for understanding the mechanisms of progression from an initial infection to AIDS.

Multidimensional vector space representation for convergent evolution and molecular phylogeny.

With growing amounts of genome data and constant improvement of models of molecular evolution, phylogenetic reconstruction became more reliable. However, our knowledge of the real process of molecular evolution is still limited. When enough large-sized data sets are analyzed, any subtle biases in statistical models can support incorrect topologies significantly because of the high signal-to-noise ratio.