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2. Low dose tacrolimus exposure and early steroid withdrawal with strict body weight control can improve post kidney transplant glucose tolerance in Japanese patients

Author

Mitsuke, Akihiko, primary, Ohbo, Takahiko, additional, Arima, Junya, additional, Osako, Yoichi, additional, Sakaguchi, Takashi, additional, Matsushita, Ryosuke, additional, Yoshino, Hirofumi, additional, Tatarano, Shuichi, additional, Yamada, Yasutoshi, additional, Sasaki, Hajime, additional, Tanabe, Tatsu, additional, Fukuzawa, Nobuyuki, additional, Tanaka, Hiroshi, additional, Nishio, Yoshihiko, additional, Hideki, Enokida, additional, and Harada, Hiroshi, additional

Published
2023
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3. Development and nationwide validation of kidney graft injury markers using urinary exosomes and microvesicles (complete English translation of the Japanese version)

Author

Harada, Hiroshi, primary, Fukuzawa, Nobuyuki, additional, Abe, Toyofumi, additional, Imamura, Ryoichi, additional, Masaki, Noriyuki, additional, Fujiyama, Nobuhiro, additional, Sato, Shigeru, additional, Hatakeyama, Shingo, additional, Nishimura, Kenji, additional, Kishikawa, Hidefumi, additional, Iwami, Daiki, additional, Hotta, Kiyohiko, additional, Miura, Masayoshi, additional, Ide, Kentaro, additional, Nakamura, Michio, additional, Kosoku, Akihiro, additional, Uchida, Junji, additional, Murakami, Taku, additional, and Tsuji, Takahiro, additional

Published
2023
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4. Development and nation-wide validation of kidney graft injury markers using urinary exosomes and microvesicles (complete English translation of the Japanese version)

Author

Harada, Hiroshi, primary, Fukuzawa, Nobuyuki, additional, Abe, Toyofumi, additional, Imamura, Ryoichi, additional, Masaki, Noriyuki, additional, Fujiyama, Nobuhiro, additional, Sato, Shigeru, additional, Hatakeyama, Shingo, additional, Nishimura, Kenji, additional, Kishikawa, Hidefumi, additional, Iwami, Daiki, additional, Hotta, Kiyohiko, additional, Miura, Masayoshi, additional, Ide, Kentaro, additional, Nakamura, Michio, additional, Kosoku, Akihiro, additional, Uchida, Junji, additional, Murakami, Taku, additional, and Tsuji, Takahiro, additional

Published
2022
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10. Urinary Retention Caused by Necrotic Tissues in the Bladder of a Female Recipient of a Living-Donor Kidney Transplant : A Case Report

Author

Muranishi, Yuki, Fukuzawa, Nobuyuki, Wada, Yoshiki, Abe, Takashige, Shinohara, Nobuo, and Harada, Hiroshi

Subjects
Kidney transplantation, Urinary retention, Female, 494.9, Valvular necrotic tissue
Abstract

We report a patient who developed urinary retention due to the presence of necrotic tissues in the bladder 5 months after kidney transplantation. The patient was a 47-year-old female who had been diagnosed with immunoglobulin A nephropathy. She requested to receive a living-donor kidney transplant from her husband, and was referred to our hospital. Given that the patient had anuria preoperatively, her bladder capacity was presumed to have decreased following the transplantation. There were no events regarding vascular anastomosis during the surgery. However, since ureteroneocystostomy was difficult to perform due to the thinning of the bladder wall, the recipient's own ureter was anastomosed to the ureter of the transplanted kidney. Since the patient had difficulty voiding soon after the indwelling urinary catheter was removed, clean intermittent self-catheterization was initiated. Abdominal computed tomography revealed perforation of the bladder and extravesical urinary leakage on postoperative day 15. An indwelling urinary catheter was reinserted as conservative treatment. We removed the indwelling urinary catheter on postoperative day 25. The patient was discharged on postoperative day 30. Five months after transplantation, the patient suddenly developed urinary retention. Cystoscopy revealed some tissue hanging from the anterior wall of the bladder. The tissue was removed, and her voiding function improved. On pathology, the tissue was found to be non-specific necrotic tissue. This finding suggested that the necrotic tissue had caused urinary retention 5 months after transplantation. The symptoms of urinary retention markedly improved after the treatment.

Published
2018

19. Safety and Efficacy of Retroperitoneoscopic Living Donor Nephrectomy: Comparison of Early Complication, Donor and Recipient Outcome with Hand-Assisted Laparoscopic Living Donor Nephrectomy

Author

Hirose, Takayuki, primary, Hotta, Kiyohiko, additional, Iwami, Daiki, additional, Harada, Hiroshi, additional, Morita, Ken, additional, Tanabe, Tatsu, additional, Sasaki, Hajime, additional, Fukuzawa, Nobuyuki, additional, Seki, Toshimori, additional, and Shinohara, Nobuo, additional

Published
2018
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Author

Muranishi, Yuki, Fukuzawa, Nobuyuki, Wada, Yoshiki, Abe, Takashige, Shinohara, Nobuo, Harada, Hiroshi, Muranishi, Yuki, Fukuzawa, Nobuyuki, Wada, Yoshiki, Abe, Takashige, Shinohara, Nobuo, and Harada, Hiroshi

Abstract

We report a patient who developed urinary retention due to the presence of necrotic tissues in the bladder 5 months after kidney transplantation. The patient was a 47-year-old female who had been diagnosed with immunoglobulin A nephropathy. She requested to receive a living-donor kidney transplant from her husband, and was referred to our hospital. Given that the patient had anuria preoperatively, her bladder capacity was presumed to have decreased following the transplantation. There were no events regarding vascular anastomosis during the surgery. However, since ureteroneocystostomy was difficult to perform due to the thinning of the bladder wall, the recipient's own ureter was anastomosed to the ureter of the transplanted kidney. Since the patient had difficulty voiding soon after the indwelling urinary catheter was removed, clean intermittent self-catheterization was initiated. Abdominal computed tomography revealed perforation of the bladder and extravesical urinary leakage on postoperative day 15. An indwelling urinary catheter was reinserted as conservative treatment. We removed the indwelling urinary catheter on postoperative day 25. The patient was discharged on postoperative day 30. Five months after transplantation, the patient suddenly developed urinary retention. Cystoscopy revealed some tissue hanging from the anterior wall of the bladder. The tissue was removed, and her voiding function improved. On pathology, the tissue was found to be non-specific necrotic tissue. This finding suggested that the necrotic tissue had caused urinary retention 5 months after transplantation. The symptoms of urinary retention markedly improved after the treatment.

Published
2018

26. Preceding T-Cell-Mediated Rejection Is Associated with the Development of Chronic Active Antibody-Mediated Rejection by de Novo Donor-Specific Antibody

Author

Tsuji, Takahiro, Iwasaki, Sari, Makita, Keishi, Imamoto, Teppei, Ishidate, Naomichi, Mitsuke, Akihiko, Fukuzawa, Nobuyuki, Harada, Hiroshi, and Fukazawa, Yuichiro

Abstract

Aim:Chronic active antibody-mediated rejection (CAABMR) is an important cause of late-stage renal allograft loss. Early inflammatory events such as acute rejection and infection after transplantation are considered to be the risk factors of de novo donor-specific antibody (dnDSA) production. In this study, we investigated the relationship between pre­disposing T-cell-mediated rejection and dnDSA-positive CAABMR. Methods:We recruited 365 patients who underwent ABO-compatible renal transplantation at our hospital. Among them, 16 patients diagnosed as having dnDSA-positive CAABMR were designated as a CAABMR group, and 38 randomly selected patients were designated as a control group. All biopsies from 1 month after transplantation were included in the study. The presence or absence of borderline changes (BLCs), acute T-cell-mediated rejection (ATMR), microvascular inflammation (MVI), and C4d positive on peritubular capillaries (C4d-P) was examined. Results:In the CAABMR group, BLC/ATMR was found in 12 cases (75%), and the mean duration until appearance of BLC/ATMR was 282.7 ± 328.7 days. C4d-P was found in 11 cases (68.8%), and the mean duration until its appearance was 1,432 ± 1,307 days. MVI was found in all cases, and the mean duration until its appearance was 1,333 ± 1,126 days. The mean duration until diagnosis of CAABMR was 2,268 ± 1,191 days. In the control group, BLC/ATMR was found in 13 cases (34.2%), and the mean duration until the appearance of BLC/ATMR was 173.1 ± 170.4 days. C4d-P was found in 2 cases (5.3%), and the durations until its appearance were 748 and 1,881 days. No cases of MVI were found in the control group. The frequency of BLC/ATMR was significantly higher in the CAABMR group (p< 0.01). Conclusion:Preceding BLC/ATMR is associated with the development of CAABMR with dnDSA.

Published
2021
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28. MP45-15 NON-INVASIVE UROTHELIAL CANCER BIOMARKERS

Author

Harada, Hiroshi, primary, Murakami, Taku, additional, Yamamoto, Cindy M, additional, Akino, Tomoshige, additional, Tanaka, Hiroshi, additional, Fukuzawa, Nobuyuki, additional, Seki, Toshimori, additional, and Mitsuhashi, Masato, additional

Published
2016
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30. A TOLL-LIKE RECEPTOR 5 AGONIST INHIBITS ACUTE RENAL ISCHEMIC FAILURE1

Author

Fukuzawa, Nobuyuki, Petro, Marianne, Baldwin, William M., Gudkov, Andrei V., and Fairchild, Robert L.

Subjects
Mice, Inbred C57BL, Mice, Toll-Like Receptor 5, Neutrophil Infiltration, Reperfusion Injury, Anti-Inflammatory Agents, Animals, Acute Kidney Injury, Peptides, Immunohistochemistry, Article
Abstract

Reperfusion of ischemic organs induces a potent inflammatory response initiated by the generation of reactive oxygen species (ROS) that directly damage tissue and promote leukocyte infiltration and activation that also mediate tissue injury. We recently found that radiation-induced tissue injury, which is caused by radiation induced ROS, is attenuated by administration of CBLB502, a pharmacologically optimized derivative of the Toll-like receptor 5 (TLR5) agonist flagellin. Therefore, we tested the ability of CBLB502 to attenuate injury in a murine model of acute ischemic renal failure. CBLB502 given 30 minutes before imposition of bilateral renal pedicle occlusion provided marked protection against the renal dysfunction and inflammation that follows reperfusion of ischemic kidneys, including marked decreases in leukocyte infiltration, proinflammatory cytokine production, and tubular injury. Importantly, CBLB502 given within 30 minutes after ischemic kidney reperfusion reproduced the protective effects of pretreatment with the TLR5 agonist, indicating a window following reperfusion in which CBLB502 administration abrogates acute renal ischemic failure. Bone marrow reconstituted chimeras were used to show that the protective effects of CBLB502 could be delivered by intact MyD88 signaling on renal parenchymal cells. Consistent with this, antibody staining of kidney sections indicated that cells lining the renal vasculature expressed TLR5. Overall, these results indicate the use of TLR5 agonists as mitigators and protectants of acute renal ischemic failure.

Published
2011

31. Long-Term Outcome of Single Institutional Experience with Conservative and Surgical Management for Renal Artery Aneurysm

Author

Morita, Ken, Seki, Toshimori, Iwami, Daiki, Sasaki, Hajime, Fukuzawa, Nobuyuki, Nonomura, Katsuya, Morita, Ken, Seki, Toshimori, Iwami, Daiki, Sasaki, Hajime, Fukuzawa, Nobuyuki, and Nonomura, Katsuya

Abstract

Background: Spontaneous rupture risk in renal artery aneurysm (RAA) is extremely low. Indication criteria for surgical repair of RAA remain uncertain. Objective: Long-term outcomes of conservative therapy and surgical repair were evaluated. Patients: The study included fifty-eight patients (17 male, 41 female) diagnosed with RAA during the last 21 years. Median age at the time of diagnosis was 62 (19-85) years old, and the median follow-up period was 69 (3-216) months. Methods: The patients were divided into two groups; conservative group (n = 30) who had been followed up with blood pressure control, and treatment group (n = 29), who underwent intervention. Results: Multiple efferent aneurysmal branches were found in seven conservative cases and 16 treatment cases (P = 0.002). The median maximum diameter of aneurysm was lower in conservative group than in the treatment group (15 versus 25 mm, P = 0.005). Two cases in conservative group showed increase in aneurysm size during follow-up. Hypertensive state had been essentially no change in both groups during follow-up. Renal function decreased with age similarly both in conservative and treatment groups. Conclusions: Our conservative management criteria for RAA are justifiable and even too strict. More loose criteria will be pursued in conservative group selection.

Published
2012

32. Successful Kidney Transplantation Ameliorates Arterial Stiffness in End-Stage Renal Disease Patients

Author

Hotta, Kiyohiko, Harada, Hiroshi, Sasaki, Hajime, 1000080581115, Iwami, Daiki, Fukuzawa, Nobuyuki, Morita, Ken, Seki, Toshimori, Togashi, Masaki, 1000060113750, Nonomura, Katsuya, Hotta, Kiyohiko, Harada, Hiroshi, Sasaki, Hajime, 1000080581115, Iwami, Daiki, Fukuzawa, Nobuyuki, Morita, Ken, Seki, Toshimori, Togashi, Masaki, 1000060113750, and Nonomura, Katsuya

Abstract

Purpose: Successful kidney transplantation (KTx) can ameliorate bodily damage caused by end-stage renal disease (ESRD). Arterial stiffness (AS) is one of the critical factors, that shorten the survival of patients due to cardiovascular events. KTx may reduce AS as well; however, this has not been investigated well. We therefore conducted a retrospective study using non-invasive pulse wave velocity (PWV), which is a useful index of aortic damage. Patients and methods: Fifty-eight consecutive kidney recipients (34 men, 24 women) were enrolled in this study. Mean age at transplantation was 40.5±12.3 years and the dialysis period was 73.1±95.8 months. The brachial-ankle PWV was measured preoperatively and six months postoperatively. First, we investigated the relationship between the PWV and the other parameters related to AS. Second, we studied the pre- to post-transplant change in PWV to evaluate the amelioration of AS after successful kidney transplantation. Results: PWV showed significant positive correlations with age, systolic blood pressure (BP), diastolic BP and abdominal aortic calcification index. After successful KTx, PWV significantly decreased. (P < 0.01) In addition, systolic and diastolic BP significantly decreased. (P < 0.01 and P < 0.05, respectively) Conclusion: Successful KTx ameliorates AS in ESRD patients. This might explain the improved cardiovascular prognosis of ESRD patients who undergo kidney transplantation.

Published
2012

37. Nihon Shoni Jinzobyo Gakkai Zasshi

Author

Okamoto, Takayuki, primary, Sasaki, Satoshi, additional, Ito, Hironobu, additional, Nakashima, Taishi, additional, Morita, Ken, additional, Miura, Masayoshi, additional, Shimoda, Naohiko, additional, Fukuzawa, Nobuyuki, additional, Nonomura, Katsuyuki, additional, and Ariga, Tadashi, additional

Published
2009
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40. Acute kidney injury caused by systemic Neisseria gonorrhoeae infection after successful kidney transplantation.

Author

Harada, Hiroshi, Mitsuke, Akihiko, Fukuzawa, Nobuyuki, Kodama, Fumihiro, Hirose, Takayuki, Tanaka, Hiroshi, Tanaka, Toshiaki, and Imamoto, Teppei

Abstract

Neisseria gonorrhoeae is one of the microbes that can causes male urethritis. This microbe is most likely to be transmitted via sexual intercourse. In men, the representative infection sites are the urethra, and oral mucosa but gonococcemia is rere. We present a case of gonococcemia in a 47‐year‐old male successful kidney recipient. He temporarily lost his graft function due to acute kidney injury followed by sepsis; however, short‐course intermittent hemodialysis and long‐term intensive ceftriaxone inoculation saved his life and his graft function. [ABSTRACT FROM AUTHOR]

Published
2018
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42. [Urinary Retention Caused by Necrotic Tissues in the Bladder of a Female Recipient of a Living-Donor Kidney Transplant : A Case Report].

Author

Muranishi Y, Fukuzawa N, Wada Y, Abe T, Shinohara N, and Harada H

Subjects
Female, Humans, Kidney Neoplasms surgery, Living Donors, Middle Aged, Necrosis complications, Urinary Bladder Diseases pathology, Kidney Transplantation, Urinary Bladder Diseases complications, Urinary Retention etiology
Abstract

We report a patient who developed urinary retention due to the presence of necrotic tissues in the bladder 5 months after kidney transplantation. The patient was a 47-year-old female who had been diagnosed with immunoglobulin A nephropathy. She requested to receive a living-donor kidney transplant from her husband, and was referred to our hospital. Given that the patient had anuria preoperatively, her bladder capacity was presumed to have decreased following the transplantation. There were no events regarding vascular anastomosis during the surgery. However, since ureteroneocystostomy was difficult to perform due to the thinning of the bladder wall, the recipient's own ureter was anastomosed to the ureter of the transplanted kidney. Since the patient had difficulty voiding soon after the indwelling urinary catheter was removed, clean intermittent self-catheterization was initiated. Abdominal computed tomography revealed perforation of the bladder and extravesical urinary leakage on postoperative day 15. An indwelling urinary catheter was reinserted as conservative treatment. We removed the indwelling urinary catheter on postoperative day 25. The patient was discharged on postoperative day 30. Five months after transplantation, the patient suddenly developed urinary retention. Cystoscopy revealed some tissue hanging from the anterior wall of the bladder. The tissue was removed, and her voiding function improved. On pathology, the tissue was found to be non-specific necrotic tissue. This finding suggested that the necrotic tissue had caused urinary retention 5 months after transplantation. The symptoms of urinary retention markedly improved after the treatment.

Published
2018
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