- 著者
- Kota Nishihama Chisa Inoue Kohei Nishikawa Yuko Okano Atsuro Takeshita Mei Uemura Taro Yasuma Toshinari Suzuki Ryuji Okamoto Corina N D'Alessandro-Gabazza Esteban C. Gabazza Yutaka Yano
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.2613-23, (Released:2023-10-27)
- 参考文献数
- 27
A 42-year-old Japanese woman with end-stage renal failure due to hypertension presented with a systolic blood pressure of 160-200 mmHg despite treatment with 4 different antihypertensive agents. The plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were elevated. Adrenal vein sampling suggested bilateral excessive aldosterone secretion, whereas adrenocortical scintigraphy showed right-dominant accumulation. Open bilateral nephrectomy and right adrenalectomy improved the systolic blood pressure, PAC, and PRA. A pathological examination revealed zona glomerulosa hyperplasia but not microaldosteronoma. This report shows that bilateral nephrectomy, not unilateral adrenalectomy, is a potentially effective treatment option for resistant hypertension with an elevated renin-angiotensin-aldosterone system in hemodialysis patients.
- 著者
- Toru Sato Yoshito Ogihara Naoki Fujimoto Akihiro Usami Tatsuya Hamaguchi Masaki Tanabe Ryuji Okamoto Shinji Nakase Kaoru Dohi
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-21-0987, (Released:2022-01-28)
- 参考文献数
- 18
- 被引用文献数
- 1
Background:The prevalence of deep venous thrombosis (DVT) among hospitalized psychiatric patients after coronavirus disease 2019 (COVID-19) infection remains unclear.Methods and Results:We retrospectively investigated the prevalence of proximal DVT after COVID-19 infection among 50 hospitalized patients in a Japanese psychiatric hospital that in which a COVID-19 cluster developed between August and September 2020. The prevalence of proximal DVT was 10.0%. Patients with proximal DVT had a lower body weight and higher maximum D-dimer levels and International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) VTE scores.Conclusions:After COVID-19 infection, hospitalized psychiatric patients are at high risk of DVT and should be carefully followed up.
- 著者
- Hiroshi Matsuo Kaoru Dohi Hirofumi Machida Hideyuki Takeuchi Toshikazu Aoki Hiroyuki Nishimura Masashi Yasutomi Michiharu Senga Takehiko Ichikawa Kentaro Kakuta Yasuhide Mizutani Akiko Tanoue Naoki Isaka Kazuki Oosugi Sukenari Koyabu Masato Sakurai Yoshihisa Fukui Hitoshi Kakimoto Tadafumi Sugimoto Takahiro Ohnishi Tomohiro Murata Eiji Ishikawa Ryuji Okamoto Tomomi Yamada Toru Ogura Yuki Nishimura Takashi Tanigawa Shinsuke Nomura Masakatsu Nishikawa Masaaki Ito
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.82, no.2, pp.586-595, 2018-01-25 (Released:2018-01-25)
- 参考文献数
- 37
- 被引用文献数
- 29
Background:The aim of this study was to assess the echocardiographic characteristics of chronic hemodialysis (HD) patients with end-stage renal disease (ESRD) in a multicenter prospective cohort study.Methods and Results:Three hundred and fifteen patients with ESRD (67.9±10.6 years, 47.6% male) on chronic HD for ≥1 year were examined on transthoracic echocardiography, including Doppler-derived aortic valve area (AVA) measurement. Only 11.5% and 3.4% of all patients had normal left ventricular (LV) geometry and normal LV filling pattern, respectively. The majority of patients had aortic and mitral valvular calcification, and approximately 50% of all 315 patients had aortic valve narrowing with AVA <2.0 cm2. Patients were divided into 3 groups according to AVA index tertile: group 1, highest tertile; group 2, middle tertile; and group 3, lowest tertile. Group 3 was older, had a greater cardiothoracic ratio on chest X-ray, higher plasma brain natriuretic peptide and total LV afterload, and lower stroke volume index than the other 2 groups. Age and intact parathyroid hormone (PTH) level were independently associated with low AVA index.Conclusions:Patients with ESRD on chronic HD have a high prevalence of cardiac structural and functional abnormalities including calcified aortic sclerosis. High age and PTH were associated with aortic valve narrowing in these patients.