|
Affiliation |
Faculty of Medicine College Hospital Hemocatharsis treatment part |
|
Title |
Associate Professor |
|
External Link |
|
KIKUCHI Masao
|
|
|
Papers 【 display / non-display 】
-
Ochiai Shoko, Iwakiri Takashi, Kikuchi Masao, Kaikita Koichi, Fujimoto Shouichi
Nihon Toseki Igakkai Zasshi 57 ( 1 ) 29 - 35 2024
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society for Dialysis Therapy
A 71-year-old male presented in 2012 with symptoms of alveolar hemorrhage, abnormal urine analysis, and renal dysfunction (serum creatinine level：4 mg/dL). The patient was positive for MPO-ANCA. Renal biopsy revealed crescentic glomerulonephritis, and he was diagnosed with ANCA-associated vasculitis. Treatment with prednisolone and various immunosuppressive drugs resolved the alveolar hemorrhage and improved the creatinine level to around 2 mg/dL. In March 2017, the patient was treated for alveolar hemorrhage with methylprednisolone pulse therapy. His renal function gradually worsened, and in October 2017, hemodialysis was initiated. At the time of initiation, alveolar hemorrhage was present, and the patient received methylprednisolone pulse therapy. Within a few days, the bloody sputum disappeared, and there were no respiratory symptoms. He had been taking trimethoprim-sulfamethoxazole to prevent pneumocystis pneumonia for a prolonged period and continued to take the drug after admission (80 mg of trimethoprim twice a week). However, on the 19<sup>th</sup> day, a nodule shadow appeared in the right middle lung field on plain chest X-ray and it was enlarging. No respiratory symptoms were present, but <i>Nocardia</i> was identified via sputum culture, ultimately leading to a diagnosis of pulmonary nocardiosis. The background of steroid therapy and induction of dialysis were considered to be the trigger for pulmonary nocardiosis in this case. Treatment with trimethoprim-sulfamethoxazole was initiated, and the nodule shadow reduced. In the early stages of dialysis initiation, there is a well-known higher incidence of tuberculosis due to cellular immunosuppression. In dialysis-initiated patients undergoing immunosuppressive therapy, <i>Nocardia</i> infection should also be considered.
DOI： 10.4009/jsdt.57.29
-
Ochiai S., Kikuchi M., Kaikita K., Fujimoto S.
Journal of Nephrology 2024
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Nephrology
-
Current treatment status of IgA nephropathy in Japan: a questionnaire survey Reviewed
Matsuzaki K., Suzuki H., Kikuchi M., Koike K., Komatsu H., Takahashi K., Narita I., Okada H.
Clinical and Experimental Nephrology 27 ( 12 ) 1032 - 1041 2023.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Clinical and Experimental Nephrology
Background: In 2020, the Committee of Clinical Practical Guideline for IgA Nephropathy (IgAN) revised the clinical practice guidelines. Herein, we conducted a questionnaire survey to assess the potential discrepancies between clinical practice guidelines and real-world practice in Japan. Methods: A web-based survey of members of the Japanese Society of Nephrology was conducted between November 15 and December 28, 2021. Results: A total of 217 members (internal physicians: 203, pediatricians: 14) responded to the questionnaire. Of these respondents, 94.0% answered that the clinical practice guidelines were referred to “always” or “often.” Approximately 66.4% respondents answered that histological grade (H-Grade) derived from the “Clinical Guidelines for IgA nephropathy in Japan, 3rd version” and the “Oxford classification” were used for pathological classification. Moreover, 73.7% respondents answered that the risk grade (R-grade) derived from the “Clinical Guidelines for IgA nephropathy in Japan, 3rd version” was referred to for risk stratification. The prescription rate of renin–angiotensin system blockers increased based on urinary protein levels (> 1.0 g/day: 88.6%, 0.5–1.0 g/day: 71.0%, < 0.5 g/day: 25.0%). Similarly, the prescription rate of corticosteroids increased according to proteinuria levels (> 1.0 g/day: 77.8%, 0.5–1.0 g/day: 52.8%, < 0.5 g/day: 11.9%). The respondents emphasized on hematuria when using corticosteroids. In cases of hematuria, the indication rate for corticosteroids was higher than in those without hematuria, even if the urinary protein level was 1 g/gCr or less. Few severe infectious diseases or serious deterioration in glycemic control were reported during corticosteroid use. Conclusion: Our questionnaire survey revealed real-world aspects of IgAN treatment in Japan.
-
Kurasawa S., Yasuda Y., Kato S., Maruyama S., Okada H., Kashihara N., Narita I., Wada T., Yamagata K., Hirayama T., Togashi N., Sugiura A., Yamagata K., Shiigai T., Ueki K., Kikkawa K., Nakamura T., Sato E., Matsukuma H., Harasawa S., Washio T., Shibuya Y., Tagawa H., Yasuda T., Kobayashi S., Nagasawa M., Wakasugi M., Yamazaki H., Matsumoto M., Maruyama S., Suga N., Tamagaki K., Kimura T., Tabata T., Tsujimoto Y., Nishi S., Yonekura Y., Sugiyama H., Sofue T., Tsuruya K., Nakano T., Tadokoro M., Fujimoto S., Kikuchi M., Tokuyama K.
Hypertension Research 46 ( 11 ) 2478 - 2487 2023.11
Publishing type：Research paper (scientific journal) Publisher：Hypertension Research
Intensive antihypertensive treatment decreases cardiovascular disease and mortality risks in chronic kidney disease (CKD), whereas extremely low systolic blood pressure (SBP) is associated with worsening kidney function and poor prognosis. Although the SBP variation is particularly large in patients with CKD, the optimal lower limit of SBP target is unclear. In a nationwide, multicenter cohort study of patients with an estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m2, we evaluated the association between the eGFR slopes and the lower limit of SBP target at ≥110 mmHg using a linear mixed-effects model and an instrumental variable method. The instrumental variable was calculated as the facility-level percentage of nephrologists who answered in the survey that their lower limit of SBP target was 110 mmHg or higher. A total of 1320 patients (mean age 70 years; 66% men) were included. The mean eGFR slope ± standard deviation over the four years to baseline was –2.48 ± 2.15 mL/min/1.73 m2/year. The instrumental variable for the lower limit of SBP target at ≥110 mmHg (vs. ≤100 mmHg) was associated with less eGFR decline (coefficient: +1.05 mL/min/1.73 m2/year; 95% confidence interval: 0.33–1.77), while unassociated with a history of cardiovascular disease. The renoprotective effect was particularly larger in the subgroups of the elderly and those with a history of cardiovascular disease. In conclusion, the lower limit of SBP target at 110 mmHg or higher was associated with improved eGFR slope, suggesting the importance of aiming at avoiding excessively low SBP in patients with advanced CKD. [Figure not available: see fulltext.]
-
Fujimoto K, Hisanaga S, Kuroda S, Kodama K, Sugiyama F, Kikuchi M, Kita T, Yamashita A, Nagai T, Kamimura T, Kaikita K, Imamura T, Fujimoto S
CEN case reports 13 ( 1 ) 1 - 8 2023.4
Language：English Publishing type：Research paper (scientific journal) Publisher：CEN Case Reports
A 42-year-old man showed marked hypokalemia after kidney transplantation. He was diagnosed with hypertension and suffered from acute myocardial infarction at 33 and 38 years of age. At 40 years of age, hemodialysis was introduced. A left adrenal tumor was noted and suspected as a non-functional adrenal adenoma at that time. Therefore, he received a living-donor kidney transplant at 42 years of age. After kidney transplantation, the serum creatinine level dropped. His blood pressure remained high, and the serum potassium level decreased. The PRA and PAC were elevated, and ARR was not elevated. Based on the results of various confirmatory tests and vein sampling, he was diagnosed with excessive secretion of renin from the native kidneys that was complicated by primary aldosteronism (PA), and left nephrectomy and adrenalectomy were performed. The overproduction of aldosterone in the resected adrenal adenoma and over secretion of renin in the kidney with arteriolosclerosis were immunohistologically confirmed. After surgery, the PAC decreased, but the PRA did not decrease. The postoperative serum potassium level improved, and the blood pressure was well controlled with a small dose of medication. This is the first reported case of PA with hyperreninemia after kidney transplantation. It should be noted that PA in dialysis patients and kidney transplant recipients may not fulfill the usual diagnostic criteria of an elevated ARR. In such patients, PA should be suspected based on the absolute value of the PAC and responsiveness to ACTH stimulation, and adrenal and renal vein sampling is required for a definitive diagnosis.
Books 【 display / non-display 】
-
第7章 患者管理。慢性腎臓病に伴う骨・ミネラル代謝異常
藤元昭一、菊池 正雄（ Role： Contributor）
医歯薬出版株式会社 2019.3
Language：Japanese Book type：Scholarly book
-
第7章 患者管理。慢性腎臓病に伴う骨・ミネラル代謝異常
藤元昭一、菊池 正雄（ Role： Contributor）
医歯薬出版株式会社 2019.3
Language：Japanese Book type：Scholarly book
MISC 【 display / non-display 】
-
閉塞性動脈硬化症に対する腸骨動脈ステント留置後長期経過して感染性動脈瘤を発症し、コイル塞栓術を行った長期血液透析患者の一例
黒田彩加、落合彰子、植村倫行、海老原尚、佐藤祐二、菊池正雄、藤元昭一
九州人工透析研究会誌 2020.10
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
-
両側腎動脈狭窄症に対する治療
菊池正雄、古郷博紀、石﨑友梨、菅井亜希、新屋琴子、麻生久美子、皆川明大、西園隆三、稲垣浩子、石川哲憲、佐藤祐二、北村和雄、藤元昭一
宮崎県医師会医学会誌 2020.9
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
-
A case of encephalopathy presenting the lentiform fork sign on MRI in a diabetic dialysis patient - diabetic
Yuri Ishizaki, Ryuzoh Nishizono, Masao Kikuchi, Hiroko Inagaki, Yuji Sato, Shouichi Fujimoto
F1000Reserch 2020.8
Language：English Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
-
IgA腎症
菊池正雄、佐藤祐二、藤元昭一
腎と透析 2020.6
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
-
急速進行性糸球体腎炎
菊池正雄
medicina 2020.4
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
Presentations 【 display / non-display 】
-
Urine aquaporin-2 messenger RNA predicts global glomerulosclerosis and renal outcome in anti-neutrophil cytoplasmic antibody-associated vasculitis
Kikuchi M, Fukuda A, Minakawa A, Sato Y, Fujimoto S
ASN kidney Week 2019
Event date： 2019.11
Language：English Presentation type：Poster presentation
-
両側大脳基底核病変を呈する代謝性脳症をきたした血液透析患者の一例
黒田彩加、石﨑友梨、西園隆三、菊池正雄、稲垣浩子、佐藤祐二、藤元昭一
第49回日本腎臓学会西部学術大会
Event date： 2019.10
Language：Japanese Presentation type：Poster presentation
-
免疫チェックポイント阻害薬関連心筋炎との鑑別に苦慮したトロポニンＴ産生篩骨洞がんの一例
鶴田敏博、佐藤勇一郎、梶原啓、川畑隆之、久富木庸子、菊池正雄、石川哲憲、東野哲也、北村和雄
第2回日本腫瘍循環器学会学術集会
Event date： 2019.9.21 - 2019.9.22
Language：Japanese Presentation type：Poster presentation
-
Ⅰ型糖尿病，微小変化型ネフローゼ症候群をほぼ同時期に発症し急性腎不全を呈した1例
櫛間菜津美、古郷博紀、石﨑友梨、新屋琴子、日髙竜太郎、崎原久美子、西園隆三、菊池正雄、佐藤祐二、藤元昭一
日本内科学会第326回九州地方会
Event date： 2019.8
Language：Japanese Presentation type：Poster presentation
-
両側大脳基底核病変を呈する代謝性脳症をきたした血液透析患者の一例
石﨑友梨、西園隆三、菊池正雄、稲垣浩子、佐藤祐二、藤元昭一
第47回宮崎県人工透析研究会
Event date： 2019.7.27
Language：Japanese Presentation type：Poster presentation
Grant-in-Aid for Scientific Research 【 display / non-display 】
-
循環器疾患の臓器障害におけるビッグアンジオテンシン-25の役割と生成機構の解明
Grant number：19K08543 2019.04 - 2022.03
科学研究費補助金 基盤研究(C)
Authorship：Coinvestigator(s)
-
循環器疾患の臓器障害におけるビッグアンジオテンシン-25の役割と生成機構の解明
Grant number：19K08543 2019.04 - 2022.03
基盤研究（C)
Authorship：Coinvestigator(s)
-
循環器疾患の臓器障害におけるビッグアンジオテンシン-25の役割と生成機構の解明
Grant number：19K08543 2019.04 - 2022.03
基盤研究（C)
Authorship：Coinvestigator(s)