Risk of macrovascular disease stratified by stage of chronic kidney disease in type 2 diabetic patients: critical level of the estimated glomerular filtration rate and the significance of hyperuricemia.


BACKGROUND:Although a high prevalence of macrovascular disease (MVD) has been reported in patients with stage 3 chronic kidney disease (CKD), few studies have reported its risk with respect to the underlying cause of kidney disease. This study investigated the prevalence of MVD in type 2 diabetic patients with CKD stratified by CKD stage, as defined by estimated glomerular filtration rate (eGFR), as well as the risk factors for MVD. METHODS:1493 patients with diabetic CKD (1273 males, 220 females) were stratified by CKD stage (stage 1: 39, stage 2: 272, stage 3: 1052, stage 4: 101, stage 5: 29) based on eGFR calculated by the Japanese formula and averaged over 8 months. MVD was defined as one of the following: coronary heart disease (CHD), stroke or arteriosclerosis obliterans (ASO). RESULTS:The prevalence of MVD was 18.6%. A significant increasing trend in MVD prevalence was observed from stage 3 (17.78%) to 4 (52.48%). According to a receiver operating characteristic curve analysis on MVD prevalence in stage 3 patients, an eGFR of 46.4 ml/min/1.73 m(2) was determined to be a critical cut-off level. Proteinuria, eGFR <60 ml/min/1.73 m(2) and hyperuricemia were independent risk factors for MVD. CONCLUSIONS:In patients with diabetic CKD, a significant increase in MVD prevalence was observed from stage 3 to 4. An eGFR of 46.4 ml/min/1.73 m(2) is a critical level that affects MVD prevalence. From the perspective of cardiorenal association, CKD stage 3 should be divided into two substages. As hyperuricemia is related to an increased risk of MVD, uric acid control may be important in reducing MVD risk in diabetic CKD.


Clin Exp Nephrol


Tanaka K,Hara S,Kushiyama A,Ubara Y,Yoshida Y,Mizuiri S,Aikawa A,Kawatzu S




Has Abstract


2011-06-01 00:00:00














  • Increased non-HDL-C level linked with a rapid rate of renal function decline in HIV-infected patients.

    abstract:BACKGROUND:The risk of developing CKD is increased in HIV-infected patients; however, the relationship between renal function decline and lipid abnormalities currently remains unclear in these patients. METHODS:A retrospective cohort study was conducted on 661 HIV-infected patients, whose estimated glomerular filtrati...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Hara M,Yanagisawa N,Ohta A,Momoki K,Tsuchiya K,Nitta K,Ando M

    更新日期:2017-04-01 00:00:00

  • Aggravated renal tubular damage and interstitial fibrosis in mice lacking guanylyl cyclase-A (GC-A), a receptor for atrial and B-type natriuretic peptides.

    abstract:BACKGROUND AND AIM:The infusion of chronic angiotensin II (Ang II) has been shown to promote renal interstitial fibrosis. To evaluate the pathophysiological significance of the natriuretic peptide-GC-A system, we infused Ang II (1.0 mg/kg/day) in GC-A-deficient mice (GC-A-KO). METHODS:We used 5 groups (Wild-Saline n =...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Yoshihara F,Tokudome T,Kishimoto I,Otani K,Kuwabara A,Horio T,Kawano Y,Kangawa K

    更新日期:2015-04-01 00:00:00

  • Determinants for the prognosis of acute renal disorders that developed during or after treatment with edaravone.

    abstract:BACKGROUND:Edaravone, a drug for treating acute ischemic stroke, has been reported to provoke acute renal disorders. In the previous study, the author evaluated the role of edaravone in the development of renal disorders in 207 patients reported as having developed them in the post-marketing survey of the drug. The ove...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Hishida A

    更新日期:2009-04-01 00:00:00

  • Early survival on maintenance dialysis therapy in South Africa: evaluation of a pre-dialysis education programme.

    abstract:BACKGROUND:Mortality in the first year of maintenance dialysis is higher than in subsequent years and, within this first year, the risk of death is highest in the first 90 days. Some studies have shown that pre-dialysis education reduces early mortality. Limited data have been published from South Africa regarding earl...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章,多中心研究


    authors: Fabian J,Van Jaarsveld K,Maher HA,Gaylard P

    更新日期:2016-02-01 00:00:00

  • Clinical efficacy and safety of dotinurad, a novel selective urate reabsorption inhibitor, in Japanese hyperuricemic patients with or without gout: randomized, multicenter, double-blind, placebo-controlled, parallel-group, confirmatory phase 2 study.

    abstract:BACKGROUND:Dotinurad, a novel selective urate reabsorption inhibitor (SURI), reduces serum uric acid levels by selectively inhibiting urate transporter 1 (URAT1) for the treatment of hyperuricemia with or without gout. We confirmed the serum uric acid lowering effect and safety of dotinurad. METHODS:This was a confirm...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Hosoya T,Sano T,Sasaki T,Fushimi M,Ohashi T

    更新日期:2020-03-01 00:00:00

  • Heavy chain deposition disease: an overview.

    abstract::Heavy chain deposition disease (HCDD) is one of three entities of monoclonal immunoglobulin deposition disease, characterized histopathologically by the presence of nodular glomerulosclerosis and glomerular and tubular deposition of monoclonal heavy chains without associated light chains. Although HCDD is an extremely...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章,评审


    authors: Oe Y,Soma J,Sato H,Ito S

    更新日期:2013-12-01 00:00:00

  • Defective renal autoregulation in the chronic bile duct ligation model of liver failure.

    abstract:BACKGROUND:Cirrhosis of the liver is often associated with an impairment of renal function that is usually not associated with consistent structural abnormalities of the renal parenchyma, but is thought to be the functional consequence of arterial underfilling and reduced arterial blood pressure. METHOD:We have used t...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Maoka T,Kawata T,Koike T,Mochizuki T,Schnermann J,Hashimoto S

    更新日期:2018-10-01 00:00:00

  • Low-energy extracorporeal shock wave ameliorates ischemic acute kidney injury in rats.

    abstract:BACKGROUND:Low-energy extracorporeal shock wave (SW) improves ventricular function in ischemic cardiomyopathy through the upregulation of vascular endothelial growth factor (VEGF). VEGF is known to play important roles in acute kidney injury (AKI), and the present study investigates the efficacy of SW for AKI by renal ...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Yoshida M,Nakamichi T,Mori T,Ito K,Shimokawa H,Ito S

    更新日期:2019-05-01 00:00:00

  • Safety and effectiveness of eculizumab for pediatric patients with atypical hemolytic-uremic syndrome in Japan: interim analysis of post-marketing surveillance.

    abstract:BACKGROUND:In 2013, eculizumab was approved for treatment of the atypical hemolytic-uremic syndrome (aHUS) in Japan, which was defined as a thrombotic microangiopathy (TMA) excluding Shiga toxin-producing Escherichia coli-HUS and thrombotic thrombocytopenic purpura. Simultaneously, post-marketing surveillance was start...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Ito S,Hidaka Y,Inoue N,Kaname S,Kato H,Matsumoto M,Miyakawa Y,Mizuno M,Okada H,Shimono A,Matsuda T,Maruyama S,Fujimura Y,Nangaku M,Kagami S

    更新日期:2019-01-01 00:00:00

  • The incidence of the nephrotic syndrome in childhood in Germany.

    abstract:BACKGROUND:The incidence of childhood nephrotic syndrome (NS) in Germany is not well known. METHODS:An ESPED-based nationwide collection of epidemiological data of children in 2005 and 2006. RESULT:The mean age of NS at onset was 5.5 ± 3.7 years. The gender ratio of boys to girls was 1.8:1. The average length of stay...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Franke I,Aydin M,Llamas Lopez CE,Kurylowicz L,Ganschow R,Lentze M,Born M

    更新日期:2018-02-01 00:00:00

  • Focal segmental glomerulosclerosis and nephrotic syndrome in a child with embryonal rhabdomyosarcoma.

    abstract::A case of nephrotic syndrome (NS) and acute renal failure (ARF) associated with embryonal rhabdomyosarcoma (RMS) in a 10-year-old boy is reported. Ultrasound revealed irregular, echogenic, circumferential urinary bladder base mass, bilateral hydroureter and hydronephrosis. Histopathology of percutaneous renal and uret...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Olowu WA,Salako AA,Adelusola KA,Sowande OA,Adetiloye VA,Adefehinti O,Osasan SA

    更新日期:2008-04-01 00:00:00

  • Profiling of kidney vascular endothelial cell plasma membrane proteins by liquid chromatography-tandem mass spectrometry.

    abstract:BACKGROUND:Vascular endothelial cells (VECs) play crucial roles in physiological and pathologic conditions in tissues and organs. Most of these roles are related to VEC plasma membrane proteins. In the kidney, VECs are closely associated with structures and functions; however, plasma membrane proteins in kidney VECs re...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Liu Z,Xu B,Nameta M,Zhang Y,Magdeldin S,Yoshida Y,Yamamoto K,Fujinaka H,Yaoita E,Tasaki M,Nakagawa Y,Saito K,Takahashi K,Yamamoto T

    更新日期:2013-06-01 00:00:00

  • Clinical pharmacological study of dotinurad administered to male and female elderly or young subjects.

    abstract:BACKGROUND:Dotinurad is a novel selective urate reabsorption inhibitor (SURI) that selectively inhibits the reabsorption of uric acid in renal tubules and promotes the excretion of uric acid into urine. In this study, the effects of age and gender on the pharmacokinetics (PK), pharmacodynamics (PD), and safety of dotin...

    journal_title:Clinical and experimental nephrology

    pub_type: 临床试验,杂志文章


    authors: Nakatani H,Fushimi M,Sasaki T,Okui D,Ohashi T

    更新日期:2020-03-01 00:00:00

  • Longitudinal change in blood pressure and risk of end-stage renal disease in a community-based cohort in Okinawa.

    abstract:BACKGROUND:The appropriate blood pressure target to prevent end-stage renal disease (ESRD) is controversial. METHODS:We examined the association between systolic blood pressure (SBP) changes and ESRD incidence in 69,575 participants from the Okinawa general population aged ≥ 20 years who underwent health check-ups in ...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Usui T,Iseki C,Iseki K,Kawakami K,Nangaku M

    更新日期:2019-11-01 00:00:00

  • Severe metabolic acidosis and hypokalemia in a patient with enterovesical fistula.

    abstract::We report a case of a 59-year-old woman who had severe metabolic acidosis and hypokalemia due to an enterovesical fistula. The patient came to our hospital complaining of systemic weakness and numbness of the fingers. She was found to have hyperchloremic metabolic acidosis (arterial bicarbonate, 2.8 mEq/l) and hypokal...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Murakami K,Tomita M,Kawamura N,Hasegawa M,Nabeshima K,Hiki Y,Sugiyama S

    更新日期:2007-09-01 00:00:00

  • Night-time blood pressure and pulse wave velocity in dialysis patients.

    abstract:BACKGROUND:Ambulatory blood pressure (ABP) monitoring and carotid-femoral pulse wave velocity (cfPWV) provide important cardiovascular risk information for dialysis patients. This study aims to evaluate the risk factors of cfPWV and the associations between ambulatory blood pressure, especially night-time blood pressur...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Li X,Jiang Q,Wu W,Xu X,Miao L,Jin L,Xue L,Huang T,Di J,Liu J,He X

    更新日期:2018-02-01 00:00:00

  • Risk factors for encapsulating peritoneal sclerosis in patients who have experienced peritoneal dialysis treatment.

    abstract:BACKGROUND:The present study was conducted to clarify the clinical risk factors related to the development of encapsulating peritoneal sclerosis (EPS), which is one of the most serious complications in patients undergoing peritoneal dialysis (PD). METHODS:The records of 78 patients with a history of PD treatment, incl...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Yamamoto R,Otsuka Y,Nakayama M,Maruyama Y,Katoh N,Ikeda M,Yamamoto H,Yokoyama K,Kawaguchi Y,Matsushima M

    更新日期:2005-06-01 00:00:00

  • Steroids and azathioprine in the treatment of IgA nephropathy.

    abstract:AIM:IgA nephropathy (IgAN) is a very common glomerulonephritis among young adults, but the best therapeutic approach has not been fully elucidated. This study evaluated the effect of two different treatment regimes in IgAN, steroids alone or in combination with azathioprine. METHODS:Among 122 patients with primary IgA...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章,随机对照试验


    authors: Stangou M,Ekonomidou D,Giamalis P,Liakou H,Tsiantoulas A,Pantzaki A,Papagianni A,Efstratiadis G,Alexopoulos E,Memmos D

    更新日期:2011-06-01 00:00:00

  • Renal pathology of ANCA-related vasculitis: proposal for standardization of pathological diagnosis in Japan.

    abstract:BACKGROUND:In Japan, systematic evaluation of the histologic parameters of anti-neutrophil cytoplasmic autoantibodies (ANCA)-related vasculitis has been performed according to the Japanese classification by Shigematsu et al. However, this classification is quite different from that of the European Vasculitis Study Grou...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章,评审


    authors: Joh K,Muso E,Shigematsu H,Nose M,Nagata M,Arimura Y,Yumura W,Wada T,Nitta K,Makino H,Taguma Y,Kaneoka H,Suzuki Y,Kobayashi M,Koyama A,Usui J,Hashimoto H,Ozaki S,Tomino Y,Yamagata K

    更新日期:2008-08-01 00:00:00

  • Chemokine/chemokine receptor-mediated inflammation regulates pathologic changes from acute kidney injury to chronic kidney disease.

    abstract::Ischemia-reperfusion injury is a main cause of acute kidney injury. Tubular necrosis and interstitial inflammatory cell infiltration are characteristic pathologic changes of acute kidney injury. The main necrotic area should be repaired with new tubular epithelial cells after the injury. On the other hand, some parts ...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章,评审


    authors: Furuichi K,Kaneko S,Wada T

    更新日期:2009-02-01 00:00:00

  • A case of encapsulating peritoneal sclerosis at the clinical early stage with high concentration of matrix metalloproteinase-2 in peritoneal effluent.

    abstract::In encapsulating peritoneal sclerosis (EPS), matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases are involved in the remodeling of peritoneal tissue. We measured the MMP-2 concentration in the peritoneal effluents of a patient with EPS who discontinued continuous ambulatory peritoneal dialysis ...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Masunaga Y,Hirahara I,Shimano Y,Kurosu M,Iimura O,Miyata Y,Amemiya M,Homma S,Kusano E,Asano Y

    更新日期:2005-03-01 00:00:00

  • Phosphorylation profile of human AQP2 in urinary exosomes by LC-MS/MS phosphoproteomic analysis.

    abstract:BACKGROUND:Aquaporin-2 (AQP2) is a key water channel protein which determines the water permeability of the collecting duct. Multiple phosphorylation sites are present at the C-terminal of AQP2 including S256 (serine at 256 residue), S261, S264 and S/T269, which are regulated by vasopressin (VP) to modulate AQP2 traffi...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Sakai M,Yamamoto K,Mizumura H,Matsumoto T,Tanaka Y,Noda Y,Ishibashi K,Yamamoto T,Sasaki S

    更新日期:2020-09-01 00:00:00

  • CD16+CD56+ cells are a potential culprit for hematuria in IgA nephropathy.

    abstract:BACKGROUND:Hematuria is the first manifestation of urinary abnormality in immunoglobulin A nephropathy (IgAN). Hematuria has recently been reported as a risk factor for deterioration of renal function; however, its cause remains unknown. METHODS:We analyzed the surface marker of peripheral blood mononuclear cells befo...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Iwatani H,Nagasawa Y,Yamamoto R,Iio K,Mizui M,Horii A,Kitahara T,Inohara H,Kumanogoh A,Imai E,Rakugi H,Isaka Y

    更新日期:2015-04-01 00:00:00

  • Clinical analysis of 207 patients who developed renal disorders during or after treatment with edaravone reported during post-marketing surveillance.

    abstract:BACKGROUND:The post-marketing surveillance of edaravone has reported serious adverse reactions, including renal and hepatic disorders. Renal disorders were the most frequently reported serious/important adverse reactions, which led to the evaluation of their causation by edaravone, their severity, and the recovery of r...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Hishida A

    更新日期:2007-12-01 00:00:00

  • Final adult height in kidney recipients who underwent highly successful transplantation as children: a single-center experience.

    abstract:BACKGROUND:Achieving a normal final adult height (FH) remains a challenge in the field of pediatric kidney transplantation (KTx). To examine the optimal approach to assuring normal FH following KTx, we retrospectively examined the post-transplant growth and FH of pediatric KTx recipients. METHODS:Since the relevant fa...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Fujii H,Chikamoto H,Akioka Y,Hattori M

    更新日期:2014-06-01 00:00:00

  • Hypocomplementemia and membranoproliferative glomeruloneophritis in children.

    abstract:BACKGROUND:The incidence of hypocomplementemia detected in the school urinary screening program in Kanagawa Prefecture, Japan, and the number of new patients with membranoproliferative glomerulonephritis (MPGN) diagnosed in our institution were decreasing during the period between 1974 and 1997. Follow-up of this study...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Iitaka K,Nakamura S,Moriya S,Koshino H,Iwanami N,Sakai T,Motoyama O

    更新日期:2005-03-01 00:00:00

  • Involvement of the transforming growth factor-β system in the pathogenesis of diabetic nephropathy.

    abstract::The manifestation of diabetic nephropathy may be a consequence of the actions of certain cytokines and growth factors. Prominent among them is transforming growth factor-β (TGF-β), which promotes renal cell hypertrophy and stimulates extracellular matrix accumulation, the two hallmarks of diabetic renal disease. In ex...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Ziyadeh FN,Isono M,Chen S

    更新日期:2002-09-01 00:00:00

  • Relationship of late arteriovenous fistula stenosis with soluble E-selectin and soluble EPCR in chronic hemodialysis patients with arteriovenous fistula.

    abstract:BACKGROUND/AIMS:Vascular access dysfunction caused by stenosis is a major complication for hemodialysis (HD) patients. However, physiopathology of late arteriovenous fistula (AVF) stenosis is still under investigation. The aim of the present study was to evaluate the association between plasma soluble EPCR (sEPCR) with...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Bilgic MA,Yilmaz H,Bozkurt A,Celik HT,Bilgic IC,Gurel OM,Kirbas I,Bavbek N,Akcay A

    更新日期:2015-02-01 00:00:00

  • pH after the first session of direct hemoperfusion with polymyxin B-immobilized fibers predicts mortality in patients with sepsis and septic shock.

    abstract:BACKGROUND:The definition of sepsis was updated to sepsis-3 in February 2016. Currently, direct hemoperfusion therapy using the polymyxin B-immobilized fiber cartridge (PMX-DHP) is widely performed to treat sepsis and septic shock. However, the prognostic factors of PMX-DHPs in patients with sepsis using the new defini...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Okubo A,Nakashima A,Doi S,Ueno T,Sasaki K,Esaki T,Masaki T

    更新日期:2018-10-01 00:00:00

  • Tubulointerstitial nephritis and IgA nephropathy in a patient with advanced lung cancer treated with long-term gefitinib.

    abstract::A 52-year-old Japanese female was admitted to our hospital for microhematuria, proteinuria and progressive renal dysfunction. Two years prior to admission, she was diagnosed with lung adenocarcinoma and multiple bone and brain metastases, and was treated with gefitinib (250 mg/day). Treatment for 6 months induced part...

    journal_title:Clinical and experimental nephrology

    pub_type: 杂志文章


    authors: Masutani K,Fujisaki K,Maeda H,Toyonaga J,Inoshima I,Takayama K,Katafuchi R,Hirakata H,Tsuruya K,Iida M

    更新日期:2008-10-01 00:00:00