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Elevated urine Mg excretion and its correlation with histological damage in tubulo-interstitial nephropathy (TIN) were reported. Here we investigated the clinical significance of the fractional excretion of Mg (FEMg) for the prediction of TIN.We enrolled and assessed 94 adult patients with various renal diseases diagnosed principally by renal biopsy.Our stratified analysis based on the value of the conventional TIN parameter N-acetylglucosaminidase (NAG) excretion showed that the high-NAG index group (more than median value of NAG-to-Cr ratio, n = 47) demonstrated significantly high FEMg values (p = 0.017). A univariate analysis revealed a significant correlation between the FEMg and the NAG index (R = 0.60) but not for other parameters. A multivariate regression analysis confirmed the significance of the FEMg as an effective predictor of the NAG index. The FEMg showed a significant correlation with the estimated glomerular filtration rate (eGFR) in the patients with eGFR ≤ 30 mL/min. The correlation of FEMg with the NAG index was not observed in the primary glomerulonephritis patients but was apparent in the patients with hypertensive nephrosclerosis or interstitial nephritis.Our findings may indicate that the combination of the FEMg and the NAG index can provide a specific, sensitive assessment for TIN in patients without renal insufficiency.

Planting time is one of the management methods determining yield potential in rice. The aims of the present study were to determine whether early transplanting improves yield potential in temperate regions of Japan, and to identify quantitative influences of climatic factors on crop productivity. We evaluated differences in biomass production and yield formation under three transplanting times for high-yielding cultivars having different heading characteristics. Early transplanting extended growth duration, but did not increase biomass production before heading, resulting in no improvement in total spikelet number and yield potential. For all the cultivars, cumulative air temperature better explained differences in biomass production under different transplanting times than did cumulative solar radiation. The results indicate that early-transplanted plants could not effectively utilize solar radiation for CO2 assimilation and that early biomass production in early-transplanted plants was constrained by low temperature. On the other hand, biomass production after heading and grain filling in late-heading cultivars were reduced with late transplanting time, owing to lower solar radiation and lower temperature. These results suggest that avoiding late transplanting can increase final biomass as well as acquire stable and high grain yield in late-heading cultivars in temperate regions, even if early biomass production after transplanting is reduced by low temperature. Two indica-dominant cultivars showed the highest grain yield and biomass productivity in the present study, but showed higher base temperature for biomass production, indicating that inidica-dominant cultivars were susceptible to low temperature. Development of a management method and genetic modification to promote early biomass productivity at low temperatures is necessary for further improvement of yield potential of high-yielding cultivars in temperate regions.

In recent times, therapy for renal anemia has changed dramatically in that iron administration has increased and doses of erythropoiesis-stimulating agents (ESAs) have decreased. Here we used a prospective, observational, multicenter design and measured the serum ferritin and hemoglobin levels every 3 months for 2 years in 1086 patients on maintenance hemodialysis therapy. The associations of adverse events with fluctuations in ferritin and hemoglobin levels and ESA and iron doses were measured using a Cox proportional hazards model for time-dependent variables. The risks of cerebrovascular and cardiovascular disease (CCVD), infection, and hospitalization were higher among patients who failed to maintain a target-range hemoglobin level and who exhibited high-amplitude fluctuations in hemoglobin compared with patients who maintained a target-range hemoglobin level. Patients with a higher compared with a lower ferritin level had an elevated risk of CCVD and infectious disease. Moreover, the risk of death was significantly higher among patients with high-amplitude ferritin fluctuations compared with those with a low ferritin level. The risks of CCVD, infection, and hospitalization were significantly higher among patients who were treated with high weekly doses of intravenous iron compared with no intravenous iron. Thus, there is a high risk of death and/or adverse events in patients with hemoglobin levels outside the target range, in those with high-amplitude hemoglobin fluctuations, in those with consistently high serum ferritin levels, and in those with high-amplitude ferritin fluctuations.

Water intoxication is a life-threatening disorder accompanied by brain function impairment due to severe dilutional hyponatremia. We treated a 22-year-old man without psychotic illness who had been put in a detention facility. He drank 6 liters of water over a 3-hour period at the facility as a game's penalty, and he showed progressive psychiatric and neurological signs including restlessness, peculiar behavior and convulsions. On his admission, 15 h after the discontinuation of the water drinking, he was in a coma, showing intermittent convulsions and remarkable hyponatremia (120 mmol/l). Because his laboratory tests showed hypertonic urine and normal sodium excretion, the diagnosis of secondary development of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was strongly suggested and later confirmed by the suppression of the renin-aldosterone system and the inappropriately elevated secretion of ADH. Saline infusion and an initial administration of furosemide in addition to dexamethasone as treatments for the patient's brain edema successfully improved his laboratory data and clinical signs by the 3rd hospital day, and he was returned to the facility without physical or psychiatric abnormalities on the 6th day. The secondary SIADH might have been due to the prolonged emesis, recurrent convulsions and rapid elevation of intracranial pressure.

Most dialysis clinics in Japan have mainly adopted the central dialysis fluid delivery system (CDDS) to provide constant treatment to many patients. Chemical disinfection is the major maintenance method of the CDDS. Our clinic introduced an automated hot water disinfection system that used the heat conduction effect to disinfect a reverse osmosis (RO) device and dialysis fluid supply equipment. Endotoxin level and the amount of viable bacteria often showed abnormal values before introduction of this system. After its introduction, weekly disinfection resulted in endotoxin levels and the amount of viable bacteria lower than measurement sensitivity. In hot water disinfection, water heated to 90°C in the RO tank flows into the dialysis fluid supply equipment. The maximum temperature inside the tank of the supply equipment is 86.3°C. (We confirmed that the temperature was maintained at 80°C or more for 10 minutes or more during the monitoring.) Dialysate purification was maintained even after introduction of the automated hot water disinfection system and the dialysate could be supplied stably by the CDDS. Therefore, this disinfection system might be very useful in terms of both cost and safety, and can be used for dialysis treatment of multiple patients.

Low temperature decreases biomass production and yield in rice through a number of physiological and morphological changes. We evaluated biomass production in 22 high-yielding genotypes and four commercial japonica cultivars early after transplanting under field conditions for 2 years. The seedlings were transplanted on 30 April or 1 May (early transplanting, ET) and 4 weeks later (late transplanting, LT). The mean air temperature during the 18 days after transplanting in ET was about 4ºC lower than that in LT in both years. The seedling length was greater in high-yielding japonica varieties than in indica genotypes, whereas the seedling character index (SCI), which is the product of plant age in leaf number and the ratio of the seedling weight to its length, was the highest in the indica genotypes. Varietal differences in biomass production were greater in ET than in LT in all rice genotypes. The biomass at 18 days after transplanting was largest in the japonica high-yielding varieties Kusayutaka and Beko-aoba in both ET and LT. The biomass production of the indica genotypes was found to decrease severely after transplanting at low temperatures although the indica genotypes with high SCIs showed faster leaf emergence than the high-yielding japonica varieties. There was a strong positive correlation between the varietal differences in biomass production and shoot length at 18 days after transplanting in ET in both years. Our study suggests that superior shoot elongation in the high-yielding japonica varieties with large biomass allocation to the stems may be advantageous in maintaining biomass productivity at low temperatures.

寒冷地の湛水直播栽培条件における水稲品種の出芽・苗立ち性およびそれに寄与する特性について十分明らかにされていないため，寒冷地で育苗箱を利用して低温土中出芽検定を行うと同時に，出芽・苗立ちに寄与する可能性がある発芽特性および嫌気発芽条件における鞘葉の伸長性についても調査を行った．その結果，低温土中出芽検定における出芽速度は，初期生育量と高い正の相関関係（r=0.773）を示し，低温での嫌気発芽条件における鞘葉の伸長速度との間に有意な正の相関関係（r=0.528）が認められた．また，低温でのシャーレ発芽条件における発芽係数と低温土中出芽検定における出芽率（r=0.376）および初期生育量（r=0.215）との有意な正の相関関係は認められたが，この要因については明らかにできなかった．

OBJECTIVE The objective of this study was to evaluate the utility of brachial artery blood flow measurement in assessing the need for arteriovenous fistula (AVF) repair. METHODS In 236 hemodialysis patients, the relationships between the brachial artery blood flow measurement results and subsequent AVF repair and prognosis were investigated. RESULTS Mean brachial artery blood flow was significantly lower in patients requiring percutaneous transluminal angioplasty (PTA; treatment group, n = 161) than in patients followed without any treatment (no treatment group, n = 64; 250.3 mL/min versus 656.7 mL/min, p

近年の気候温暖化で水稲の登熟期間中の気温が上昇し，白未熟粒の多発による品質低下が問題となっている．深水栽培は白未熟粒の発生抑制に有効であるが，効果の大きい水深18 cmの深水栽培が可能な圃場は限られる．そこで，高温登熟耐性が弱の初星と中程度のコシヒカリを用いて，慣行栽培と水深18 cmの強深水栽培に加えて，深水栽培と同様に分げつ発生を抑制する深植（植付深6 cm）と，比較的水深が浅い弱深水栽培（水深10 cm），および両者の組み合わせについて，水稲の生育と収量，品質に及ぼす影響を比較・検討した．その結果，初星では，深植した水稲に活着期から最高分げつ期にかけて水深10 cmの深水栽培を行うと，白未熟粒の発生が減少し，水深18 cmの深水栽培でみられた減収傾向はなく，収量が安定的に確保された．コシヒカリでは，水深18 cmの深水栽培をしても，有意に収量は低下せず，この栽培条件で品質が最も高かった．また，コシヒカリでも，深植水稲の水深10 cmの深水栽培では，有意な収量低下がなく，水深18 cmの深水処理に次いで白未熟粒割合も低くなった．深水栽培により，土壌の酸化還元電位が低下したが，登熟期の根系の機能に悪影響はみられなかった．深水栽培により明確な地耐力の低下はみられなかったことから，収穫時の機械作業に支障をきたす可能性は低いと考えられた．

水稲を深水栽培すると，減収を伴わず白未熟粒の発生が抑えられる．本試験では，深水栽培による白未熟粒発生抑制の生理的機構を，高温登熟耐性の異なる3品種（初星とササニシキ：弱，コシヒカリ：中）を用いて，シンクである籾と稲体のソース機能に着目して解析した．白未熟粒は胚乳のデンプン粒の充実不足により発生するため，その発生抑制には，子実への炭水化物転流量の増加が有効である．分げつ盛期から最高分げつ期に，水深18 cmの深水処理を行うと，穂揃い期における籾あたりの葉鞘と稈の非構造性炭水化物（NSC）量は増加した．また，穂揃い期における籾あたりの葉身窒素含有量は深水処理により増加した．さらに，深水処理をした水稲は，登熟期に枯死する葉身が少なく，登熟期の後半も葉面積が確保された．以上のことから，深水栽培では出穂前に茎葉に蓄積される炭水化物が多く，また登熟期間を通して葉の光合成機能が高く維持され，籾へ転流される炭水化物が増加し，白未熟粒の発生が抑制されると考えられた．．

寒冷地においてエアーアシスト条播機と鉄コーティング種子を利用した直播栽培法を確立する目的で，湛水直播栽培における鉄コーティング種子の防鳥効果とその要因について検討し，湛水土中播種条件における鉄コーティング種子の出芽・苗立ち特性を催芽種子および過酸化カルシウムコーティング種子と比較した．鉄コーティング種子は，圃場条件において過酸化カルシウムコーティング種子に比べて防鳥効果があることが確認された．この要因の一つとして，鉄コーティング種子表面の色差は，過酸化カルシウムコーティング種子に比べてL*値（明度）が小さく，酸化に伴ってa*値とb*値が大きくなる（赤みと黄みが増す）ことによって土壌表面と似た色となるため，鳥害が生じにくいことが示唆された．一方，鉄コーティング種子は過酸化カルシウムコーティング種子に比べて低温条件や播種深が深くなるのに伴って出芽・苗立ちが遅れ，出芽・苗立ち率は低下して初期生育量が小さくなることが示唆された．以上の結果，鉄コーティング種子を利用する場合には表面播種とし，寒冷地では出芽・苗立ちを早進化させる技術の導入が必要であると考えられた．

水稲の湛水直播のためのエアーアシスト条播（空気を種籾に作用させることで，条を形成し，適切に種籾を埋没させる播種）技術について検討した．市販の粒状物散布機の作業幅を広げ，トラクタ装着型とし，さらに噴頭を試作することによりエアーアシスト条播機を開発した．播種様式を改善することを狙い，従来の噴頭よりも長さを伸ばし，先端の径を絞ったものを試作噴頭とした．ハイスピードカメラによる種籾の挙動解析および土槽への播種により，試作噴頭によるエアーアシスト効果を明らかにした．その結果，試作噴頭を用いたとき，種籾の落下速さは4～7m/sであり，落下方向は鉛直に対して7.1°であった．試作噴頭を用いることで条の幅は従来の40％となり，より深く埋没されることを確認した．寒天ゲルへの播種により，50～80mm程度の幅で条を形成し，5mm未満の深さで種籾が埋没されることを客観的な指標として提示した．以上より，試作噴頭を装着したエアーアシスト条播機が水稲の湛水直播に有用であることを確認した．

長期型バスキュラーカテーテル（VC）の恒久的なバスキュラーアクセス（VA）に規定しない使用方法を検討した．対象症例は，全身状態不良な腎不全患者47例（男26例，女21例）で，急性腎不全（ARF）21症例，慢性腎不全（CRF）26症例（導入例16例，慢性透析患者10例）であった．平均年齢は66±14歳，平均血清アルブミン値（Alb）は2.37±0.54 g/dL，CRPは5.14±5.36 mg/dLであった．長期型VCの使用本数は48本で，留置部位は右内頸静脈44例，左内頸静脈3例，左鎖骨下静脈1例で，平均留置期間は49.5±56日であった．長期型VCの転帰は，内シャント（AVF）作製による抜去16例，死亡16例（悪性腫瘍関連死9例，敗血症7例），感染徴候による抜去5例，透析離脱4例，閉塞・脱血不良2例，継続2例などであった．AVF造設，死亡，透析離脱を除いた長期型VCの開存率は，挿入後30日で約80％，90日でも約60％あった．全身状態不良なARFおよびCRF症例に長期型VCを使用することで，平均7週間の安定した血液透析療法が施行できた．長期型VCは恒久的なVAとしての適応以外に，早期のAVF作製困難なCRF症例におけるbridging VAおよび短期間での透析離脱が難しいARF症例などのVAとしても有用と考えられた．

エアーアシスト条播機と鉄コーティング種子を利用した湛水直播栽培体系を確立する目的で， 異なる酸化程度とした鉄コーティング種子を供試してホッパーおよびバットに集積して酸化を進めた条件において種子の発熱と発芽率の推移を調査し，同時に圃場を使った機械播種条件で出芽・苗立ちを検討した．ホッパーに集積した条件では，還元鉄（密封）区では集積後，短時間で発熱および発芽率の低下が確認され，酸化鉄（密封）区では発熱および発芽率の低下は緩やかに進行した．また，圃場およびポット試験の結果，播種後（集積後）の発芽率は酸化鉄（密封）区，還元鉄（密封）区，還元鉄（酸化）区の順となり，この結果が苗立ち率および茎葉部乾物重に反映された．以上の結果，催芽種子に酸化鉄をベースに鉄コーティングした種子では，発熱リスクを回避し易く，圃場の大規模化あるいは大区画化に対応した機械播種体系において出芽・苗立ちを確保しやすいことが示唆された．

Objective It has been reported that hyporesponsiveness to erythropoiesis-stimulating agent (ESA) is associated with adverse events in patients on maintenance hemodialysis (MHD). However, it has not been determined whether higher iron storage is associated with an improved response, including better survival, to ESA. Design and Method We measured serum ferritin, hemoglobin (Hb), and transferrin saturation (TSAT) levels every three months for two years in 1,095 MHD patients. The weekly dose of ESA to Hb ratio was also calculated as an index of ESA responsiveness (ERI). Results A significant correlation (p280); however, serum ferritin and TSAT levels did not predict a higher ERI. In the time-dependent Cox hazard model, the risk for a composite event in the patients with a high ERI (≥280) and a high ferritin level (≥100 ng/mL) was significantly greater (hazard ratio [HR], 2.09, P = 0.033) than that for patients with a high ERI and a low ferritin (

We investigated the pathophysiological significance of the mature form of adrenomedullin (AM) in hemodialysis (HD) patients. Thirty-nine HD patients were enrolled and divided into two groups: those undergoing ultrafiltration (UF) during an HD session, group I; and those not undergoing UF, group II. We measured mature AM, atrial natriuretic peptide (ANP), endothelin-1, nitric oxide, cyclic guanosine 3',5'-monophosphate, and catecholamine levels at 1-hour intervals during HD sessions. On-line optical measurement of hematocrit was used to estimate change in blood volume during HD. In group II, blood volume did not change significantly during HD, nor did plasma mature AM concentrations estimated at the beginning and end of the HD treatment (3.0 +/- 0.3 and 2.8 +/- 0.2 fmol/mL, respectively). However, blood volume decreased significantly in group I patients (-7.3% +/- 0.6%), as did plasma mature AM concentrations (from 4.4 +/- 0.3 to 3.1 +/- 0.3 fmol/mL; P0.01). In contrast to mature AM, plasma ANP concentrations declined in both groups (from 193 +/- 32 to 87 +/- 14 pg/mL in group I and 67 +/- 12 to 46 +/- 8 pg/mL in group II). We conclude that mature AM is a useful marker to evaluate circulating blood volume in HD patients. Circulating blood volume may regulate the conversion of AM from the inactive to the mature form.

To clarify the effect of artificial dwarfing induced by uniconazole-P, a gibberellin biosynthesis inhibitor, on the snow tolerance of faba bean, we examined the snow damage, non-structural carbohydrate (NSC) concentration, and resistance to snow molds of the seedlings treated with uniconazole-P. Artificial dwarfing markedly decreased snow damage caused by continuous snow cover for 62 days. NSC concentration, which affects physiological snow tolerance and snow mold resistance, was lower in dwarfed plants than in non-dwarfed plants. However, there was no difference in the rate of decrease of NSC concentration between dwarfed and non-dwarfed plants under cold and dark conditions simulating snow cover. In inoculation tests, the lesions of Pythium iwayamai and Sclerotinia trifoliorum on the leaves detached from dwarfed plants were shorter than those on the leaves from non-dwarfed plants. In artificially dwarfed plants, the leaves were thicker and darker in color, and mesophyll cells were larger and denser than those in the non-dwarfed plants. Our findings suggest that the artificial dwarfing caused by uniconazole-P increased the resistance of the leaves to snow molds, thereby increasing snow tolerance, without increasing NSC concentration. The microstructural changes that occur with dwarfing may be a factor in snow tolerance.

Pseudoelasticity (PE) is clearly seen in Fe–28Mn–6Si–5Cr shape memory alloy exhibiting non-thermoelastic martensitic transformation, especially in the sheets hot rolled with a low finishing temperature (FT). Comparison between the temperature dependence of PE and that of shape memory effect (SME) indicates that the γ ⇔ e transformation is responsible not only for the SME but also for the PE. As a result of consideration including variations in 0.2% proof stress and 2.0% flow stress with temperature, it is concluded that PE depends on the amount of the deformation due to the γ → e transformation, the external stress and some temperature-dependent effects which balance against the ‘back stress’ on unloading. Effects of temperature and low-FT hot rolling on PE are discussed on the bases of the above-mentioned factors.

The varietal differences in the contents of mineral nutrients in leaves under snow cover was examined in relation to the morphological characteristics of shoots in 16 varieties of broad beans. By snow coverage, the necrotized leaf area of the plant was increased and the contents of K, Ca and Mg in the leaves were decreased. The decrease in the mineral nutrient contents and the increase in necrotized leaf area by snow coverage were less in the snow-tolerant varieties than in vulnerable varieties, implying that mineral nutrients do not leach out easily in the tolerant varieties. Therefore, the wax content related to wettability and the number of wounds on the leaf surface which promote leaching out of mineral nutrients were measured. The tolerant varieties did not contain much wax on the leaf surface, but had a smaller number of wounds, which were caused by graupel fall with strong wind before snow covering, than the vulnerable varieties. Furthermore, in tolerant varieties, the plant height, internode and petiole were short, and total leaf area, leaf area touching on ground and intercellular space of the leaves were small. These morphological characteristics showed a close relationship with the number of wounds. These results suggest that the tolerant variety does not leach out a large amount of mineral nutrients under snow through avoidance of wounding, and that the morphological characteristics of broad bean affect snow tolerant.

Shape memory effect in an Fe28Mn6Si5Cr Alloy is improved by lowering the finishing temperature of hot-rolling through a textural effect which was already proved to exist and an additional effect. This latter effect can be attributed to a thermomechanical effect similar to ‘training’.

Background. Patients with impaired renal function have been known to have elevated concentrations of serum pepsinogens, which are raised by Helicobacter pylori infection of the stomach. The present study was performed to examine the effect of H. pylori infection on serum pepsinogen concentrations in dialysis patients. Methods. Forty nine patients on dialysis and 48 subjects with no known kidney disease were examined for upper gastroduodenal endoscopy, H. pylori infection and serum concentrations of pepsinogen I and II. The status of H. pylori infection was evaluated from results of a urease test, histology and culture of biopsy specimens of the gastric mucosa. Serum pepsinogen levels were measured by radioimmunoassay. Results. Serum concentrations of pepsinogen I and II were elevated in the dialysis patients in comparison with those in the controls (277.4±24.2 vs 52.6±4.0 pg/ml, P

The efficacy and safety of combination therapy with amoxicillin, lansoprazole, and plaunotol for the eradication of Helicobacter pylori in patients on dialysis were evaluated. The study subjects comprised 15 dialysis patients in whom H pylori had been found in the gastric mucosa. The patients were given 500 mg amoxicillin once a day for 3 weeks, 30 mg lansoprazole once a day for 8 weeks, and 80 mg plaunotol three times a day for 24 weeks. Endoscopy was performed on entry and at 4 and 24 weeks after cessation of amoxicillin. The concentrations of serum gastrin and gastric juice ammonia also were measured. Fourteen patients completed the treatment protocol, one having dropped out because of nausea and diarrhea. H pylori was eradicated in 11 of the 14 patients 4 weeks after the end of amoxicillin therapy (eradication rate, 78.6%). All but one patient was free of H pylori 24 weeks after the amoxicillin was discontinued. Patients who became negative for H pylori had significantly decreased serum gastrin and gastric juice ammonia concentrations. Our findings indicate that a combination of amoxicillin, lansoprazole, and plaunotol can be used to eradicate H pylori in patients on dialysis.

Collagenofibrotic glomerulonephropathy is a recently recognized disease entity. Although an autosomal recessive inheritance pattern has been suggested for this condition, there are few reports of familial cases. Only four pairs of child siblings, with histological confirmation of the glomerular lesions, have been reported. The current report describes a family including two sisters with histological evidence of collagenofibrotic glomerulonephropathy. Serum concentrations of the procollagen III peptide were elevated in the affected sisters, whereas their parents and other siblings demonstrated neither proteinuria nor increased blood levels of the procollagen III peptide. Our findings support an autosomal recessive pattern of inheritance for this type of glomerulonephropathy. They also suggest that the serum concentration of the procollagen III peptide is a useful marker for collagenofibrotic glomerulonephropathy.

Helicobacter pyloriは上部消化管粘膜病変の病因に重要な役割を果たしていると考えられている. Helicobacter pyloriが検出された維持血液透析患者の難治性胃潰瘍におけるHelicobacter pyloriの除菌を試み, その結果潰瘍が治癒した症例を経験したので報告する.症例は45歳, 男性で1990年9月より維持血液透析 (HD) を開始し, 1992年8月に胃潰瘍を合併した. 潰瘍はomeprazoleやranitidineの投与によりH2 Stageまで改善したが, 再びH1 stageに増悪した. このとき施行した胃粘膜生検組織の培養によりHelicobacter pyloriが検出された. Helicobacter pyloriの除菌を目的にamoxicillin (750mg, 毎透析終了時内服) を投与したところHelicobacter pyloriは消失し, 潰瘍も治癒した. 18か月後の内視鏡検査でも潰瘍の再発はなくHelicobacter pyloriも検出されていない.

This report describes a case of light chain deposition disease (LCDD) with unusual findings of fibrillar structures in the deposits and marked calcification in several organs. A forty-year-old man was initially diagnosed with LCDD in 1987, and died of sepsis three and one-half-years later. Histological examination of autopsy specimens demonstrated eosinophilic amorphous materials, which differed from amyloid, in vessel walls or around parenchymal cells in almost every organ examined. Ultrastructurally, in addition to granular deposits, fibrillar structures were also seen in the deposits. Marked calcification was present in the myocardium, skeletal muscles, adrenal glands and arteries.

The prognosis of patients on hemodialysis (HD) was determined with respect to cardiovascular disease. We analyzed the relationships between several parameters of carotid artery echograms and cardiovascular events (CVE) in patients on HD. We also compared the characteristic findings of carotid artery echography in patients with stroke and patients on HD.We enrolled 104 patients on HD (male : female, 72: 32; mean age, 63.0 +/- 11.2 years) and 48 with stroke (male : female, 36: 12; mean age, 66.0 +/- 7.7 years) who were admitted to our hospital between 1998 and 2004. We measured intima media thickness (IMT), plaque score (PS), resistive index (RI), common carotid artery (CCA) stenosis and plaque echogenicity using B-mode ultrasonography. The correlation between carotid artery echographic findings and CVE were analyzed over a period of 37.5 +/- 22.9 months of follow-up. The characteristic findings of carotid artery echography were compared among groups of patients on initial HD (iHD) and maintenance HD (mHD) and with stroke accompanied by eGFR60 mL/min/1.73 m2.Both PS and RI significantly correlated with CVE (p0.005 and p0.05, respectively), and CVE occurred at the early phase of follow up in patients with increased PS. Both PS and RI were also higher in mHD than in stroke (p0.005). Both PS and CCA stenosis were higher in mHD than in iHD (p0.01, p0.05). More hard plaques were identified in patients on mHD than in those with stroke (p0.005). Multivariate analysis showed that the numbers of soft and hard plaques were significantly associated with CCA stenosis(p0.05) and the duration of dialysis (p0.05), respectively.Increasing PS and RI were powerful predictors of CVE in patients on HD. Atherosclerotic changes were equal in patients on iHD and those with stroke. Plaque score, the numbers of hard plaques and CCA stenosis were increased in mHD, suggesting the development of atherosclerotic changes in patients on HD.

Background: Increased peritoneal solute transport rate (PSTR) is primarily a consequence of continuous exposure to bioincompatible glucose-based peritoneal dialysis (PD) solutions. However, relationships between increasing PSTR and dialysate glucose load remain unclear. As some PD patients with preserved residual renal function do not show increased PSTR despite long-term PD, we examined whether loss of residual renal function is associated with increased PSTR on long-term PD. Methods: We evaluated 35 patients who started PD between 1997 and 2002 and received continuous PD treatment for >6 years. Data included baseline clinical data, residual renal function, urea and creatinine clearance, dialysate glucose load, ultrafiltration, and the use of icodextrin and renin-angiotensin system inhibitors. Peritoneal equilibration test results and data were collected annually for 6 years. Results: Both the glomerular filtration rate and urine volume at 6 years on PD showed significant negative correlations with the dialysate-to-plasma creatinine ratio (D/P Cr) at 6 years (r = –0.716 and r = –0.717, respectively). Multivariate analysis showed only urine volume at 6 years on PD as an independent covariate of the D/P Cr at 6 years on PD. Conclusions: Loss of residual renal function is directly associated with increased PSTR in patients on long-term PD.