6 results on '"Shunya Uchida"'
Search Results
2. Rhabdomyolysis-induced acute kidney injury requiring hemodialysis after a prolonged immobilization at home in 2 morbidly obese women: case reports with literature review
- Author
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Kazuhiro Sakai, Hiroki Omizo, Ryo Togashi, Yuto Hayama, Masaki Ueno, Yoshihiro Tomomitsu, Yoshikazu Nemoto, Shinichiro Asakawa, Michito Nagura, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Shunya Uchida, Shigeru Shibata, and Yoshihide Fujigaki
- Subjects
Acute kidney injury ,Body mass index ,Creatine kinase ,High cut-off membrane ,Medium cut-off membrane ,Morbidly obesity ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Rhabdomyolysis may develop into acute kidney injury (AKI), a life-threatening complication. Obese people are at risk for rhabdomyolysis due to prolonged immobilization. However, there are only a few reports of rhabdomyolysis-induced AKI due to prolonged immobilization after falls in morbidly obese people. Myoglobin is a causative compound for rhabdomyolysis-induced AKI, but the lack of treatments targeting its mechanism is a problem. Case presentation Two morbidly obese women (body mass index > 40.0 kg/m2) who fell on the floor at home and remained in the same posture for more than 12 h developed rhabdomyolysis-induced AKI. Both patients received aggressive fluid resuscitation but required hemodialysis because of persistent oliguria. They underwent 11 and 2 intermittent hemodialysis (HD) sessions with a conventional polymethylmethacrylate (PMMA) high-flux dialyzer, respectively, and their renal functions returned to baseline after withdrawal of HD. Conclusions We should be aware that morbidly obese people are at risk for rhabdomyolysis-induced AKI due to prolonged immobilization, such as after falls. At present, prophylactic renal replacement therapy (RRT) is not recommended for rhabdomyolysis. We need to reevaluate whether RRT using the appropriate membranes to effectively remove myoglobin including the PMMA membrane can improve the renal outcome in patients with rhabdomyolysis-induced AKI.
- Published
- 2020
- Full Text
- View/download PDF
3. Factors associated with employment in patients undergoing hemodialysis: a mixed methods study
- Author
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Hideyo Tsutsui, Kyoko Nomura, Aya Ishiguro, Yoshinari Tsuruta, Sawako Kato, Yoshinari Yasuda, Shunya Uchida, and Yoshiharu Oshida
- Subjects
Dialysis shift ,Employment ,Hospital visits ,Patients undergoing hemodialysis ,Physical symptoms ,Vascular access ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background For patients undergoing hemodialysis, continuing in labor is very challenging and many patients have difficulty in current and/or previous workplaces. The objective of the present study is to clarify the determinants of being employed in hemodialysis patients by use of the mixed methods approach. Methods One hundred and forty-nine patients undergoing hemodialysis were interviewed between 2010 and 2011 using the “100-category checklists” based on the International Classification of Functioning, Disability and Health developed for hemodialysis patients. The categories with which the participants experienced difficulty at workplace were analyzed using the mixed methods approach. In quantitative data, the patients undergoing hemodialysis were divided into two groups if they experienced any difficulty in current and/or previous workplaces (i.e., “experienced” group vs. “not experienced” group). In qualitative data, responses to the open-ended questions were analyzed using a grounded theory approach. Results In total of 149 patients (male, 66%; mean age 62 years; mean hemodialysis vintage, 8.6 years), 62% had diabetes and 86% were in labor at the time of investigation. In a quantitative analysis, compared to the unexperienced group, the experienced group was more likely to show the physical problems such as fatigability and decline of physical strength and declined energy level. In a qualitative analysis, three determinants of being unemployed were emerged including hospital visits (i.e., three times a week), vascular access, and physical symptoms. In contrast, a favorable determinant for the work continuation and job opportunities was found to be a flexible dialysis shift. Conclusions Our mixed methods study suggests that patients undergoing hemodialysis frequently suffer from physical problems such as frequent hospital visits for hemodialysis, vascular access troubles, and physical distress, resulting in frequent unemployment. One solution for unemployment of the patients undergoing hemodialysis is a dialysis shift flexible for individual lifestyles.
- Published
- 2017
- Full Text
- View/download PDF
4. Effect of uric acid-lowering therapy on renal function in patients with chronic kidney disease: a systematic review and meta-analysis
- Author
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Kimiyoshi Ichida, Naoki Sugano, Shigetaka Yoshida, Shunya Uchida, Takanori Kumagai, and Yukio Maruyama
- Subjects
Nephrology ,medicine.medical_specialty ,Urology ,Allopurinol ,Renal function ,Topiroxostat ,chemistry.chemical_compound ,Febuxostat ,Internal medicine ,medicine ,Hyperuricemia ,Transplantation ,business.industry ,Xanthine oxidoreductase inhibitor ,medicine.disease ,Diseases of the genitourinary system. Urology ,chemistry ,Meta-analysis ,Renoprotective effect ,RC870-923 ,business ,medicine.drug ,Kidney disease - Abstract
Background Whether uric acid (UA)-lowering therapy (ULT) is effective in reducing the progression of renal dysfunction in patients with chronic kidney disease (CKD) remains controversial. Since several advances have been made in therapies for hyperuricemia, including novel xanthine oxidoreductase (XOR) inhibitors, we conducted a systematic review to clarify the effectiveness of ULT in preserving renal function among CKD patients. Methods In this systematic review, the MEDLINE database was searched up to June 2019. We included complete randomized controlled trials comparing renal events between adult non-dialyzed CKD patients, defined as estimated glomerular filtration rate (eGFR) 2, with and without ULTs. Changes in eGFR were expressed as the mean difference (MD). The incidence of dichotomous outcomes was expressed as a risk ratio. This review was performed using the predefined protocol published in PROSPERO (CRD 42019140346). Results Eleven studies with 4277 CKD patients were included. Drugs used in the intervention groups of all studies were XOR inhibitors (allopurinol, febuxostat or topiroxostat). Although patients with ULT tended to show superior preservation of eGFR as compared to those without ULT, no significant differences were identified (MD, 2.52; 95% confidence interval, − 0.15 to 5.18). In subgroup analysis, the use of allopurinol was associated with superior preservation of eGFR, whereas the newer XOR inhibitors, febuxostat and topiroxostat, showed no significant effects on eGFR changes. Neither incidence of end-stage kidney disease nor treatment-emergent adverse events differed significantly between groups. Conclusions The present systematic review and meta-analysis suggested that CKD patients with ULT tend to show superior eGFR preservation as compared to patients without ULT, but further studies are needed to verify the renoprotective effects of ULT.
- Published
- 2021
5. Rhabdomyolysis-induced acute kidney injury requiring hemodialysis after a prolonged immobilization at home in 2 morbidly obese women: case reports with literature review
- Author
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Yoshihide Fujigaki, Shunya Uchida, Hiroki Omizo, Kazuhiro Sakai, Shigeru Shibata, Yoshifuru Tamura, Yoshikazu Nemoto, Ryo Togashi, Osamu Yamazaki, Masaki Ueno, Shinichiro Asakawa, Michito Nagura, Yuto Hayama, Shigeyuki Arai, and Yoshihiro Tomomitsu
- Subjects
Nephrology ,medicine.medical_specialty ,Resuscitation ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,lcsh:RC870-923 ,03 medical and health sciences ,0302 clinical medicine ,High cut-off membrane ,Oliguria ,Internal medicine ,Morbidly obesity ,medicine ,Renal replacement therapy ,Creatine kinase ,Body mass index ,Transplantation ,business.industry ,Acute kidney injury ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,female genital diseases and pregnancy complications ,Anesthesia ,Hemodialysis ,medicine.symptom ,Medium cut-off membrane ,Complication ,business ,Rhabdomyolysis - Abstract
BackgroundRhabdomyolysis may develop into acute kidney injury (AKI), a life-threatening complication. Obese people are at risk for rhabdomyolysis due to prolonged immobilization. However, there are only a few reports of rhabdomyolysis-induced AKI due to prolonged immobilization after falls in morbidly obese people. Myoglobin is a causative compound for rhabdomyolysis-induced AKI, but the lack of treatments targeting its mechanism is a problem.Case presentationTwo morbidly obese women (body mass index > 40.0 kg/m2) who fell on the floor at home and remained in the same posture for more than 12 h developed rhabdomyolysis-induced AKI. Both patients received aggressive fluid resuscitation but required hemodialysis because of persistent oliguria. They underwent 11 and 2 intermittent hemodialysis (HD) sessions with a conventional polymethylmethacrylate (PMMA) high-flux dialyzer, respectively, and their renal functions returned to baseline after withdrawal of HD.ConclusionsWe should be aware that morbidly obese people are at risk for rhabdomyolysis-induced AKI due to prolonged immobilization, such as after falls. At present, prophylactic renal replacement therapy (RRT) is not recommended for rhabdomyolysis. We need to reevaluate whether RRT using the appropriate membranes to effectively remove myoglobin including the PMMA membrane can improve the renal outcome in patients with rhabdomyolysis-induced AKI.
- Published
- 2020
6. Factors associated with employment in patients undergoing hemodialysis: a mixed methods study
- Author
-
Kyoko Nomura, Yoshinari Yasuda, Aya Ishiguro, Hideyo Tsutsui, Shunya Uchida, Yoshinari Tsuruta, Sawako Kato, and Yoshiharu Oshida
- Subjects
Employment ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,media_common.quotation_subject ,030232 urology & nephrology ,lcsh:RC870-923 ,Physical strength ,Grounded theory ,03 medical and health sciences ,0302 clinical medicine ,Physical symptoms ,International Classification of Functioning, Disability and Health ,Diabetes mellitus ,Medicine ,030212 general & internal medicine ,Dialysis shift ,Dialysis ,media_common ,Patients undergoing hemodialysis ,Transplantation ,Hospital visits ,business.industry ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Distress ,Nephrology ,Unemployment ,Physical therapy ,Vascular access ,Hemodialysis ,business - Abstract
Background For patients undergoing hemodialysis, continuing in labor is very challenging and many patients have difficulty in current and/or previous workplaces. The objective of the present study is to clarify the determinants of being employed in hemodialysis patients by use of the mixed methods approach. Methods One hundred and forty-nine patients undergoing hemodialysis were interviewed between 2010 and 2011 using the “100-category checklists” based on the International Classification of Functioning, Disability and Health developed for hemodialysis patients. The categories with which the participants experienced difficulty at workplace were analyzed using the mixed methods approach. In quantitative data, the patients undergoing hemodialysis were divided into two groups if they experienced any difficulty in current and/or previous workplaces (i.e., “experienced” group vs. “not experienced” group). In qualitative data, responses to the open-ended questions were analyzed using a grounded theory approach. Results In total of 149 patients (male, 66%; mean age 62 years; mean hemodialysis vintage, 8.6 years), 62% had diabetes and 86% were in labor at the time of investigation. In a quantitative analysis, compared to the unexperienced group, the experienced group was more likely to show the physical problems such as fatigability and decline of physical strength and declined energy level. In a qualitative analysis, three determinants of being unemployed were emerged including hospital visits (i.e., three times a week), vascular access, and physical symptoms. In contrast, a favorable determinant for the work continuation and job opportunities was found to be a flexible dialysis shift. Conclusions Our mixed methods study suggests that patients undergoing hemodialysis frequently suffer from physical problems such as frequent hospital visits for hemodialysis, vascular access troubles, and physical distress, resulting in frequent unemployment. One solution for unemployment of the patients undergoing hemodialysis is a dialysis shift flexible for individual lifestyles.
- Published
- 2017
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