Updated on 2024/03/21


Graduate School of Medicine Program in Integrated Medicine Assistant Professor
Graduate School
Graduate School of Medicine
Undergraduate School
School of Medicine Department of Medicine
Assistant Professor

Degree 1

  1. Doctor of Medicine ( 2020.10   Nagoya University ) 

Research Areas 1

  1. Life Science / Nephrology


Papers 5

  1. Residual Kidney Function and Cause-Specific Mortality Among Incident Hemodialysis Patients Reviewed International coauthorship

    KIDNEY INTERNATIONAL REPORTS   Vol. 8 ( 10 ) page: 1989 - 2000   2023.10

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    Authorship:Lead author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Kidney International Reports  

    Introduction: The survival benefit of residual kidney function (RKF) in patients on hemodialysis is presumably due to enhanced fluid management and solute clearance. However, data are lacking on the association of renal urea clearance (CLurea) with specific causes of death. Methods: We conducted a longitudinal cohort study of 39,623 adults initiating thrice-weekly in-center hemodialysis from 2007 to 2011 and had data on renal CLurea and urine volume. Multivariable cause-specific proportional hazards model was used to examine the associations between baseline RKF and cause-specific mortality, including sudden cardiac death (SCD), non-SCD cardiovascular death (CVD), and non-CVD. Restricted cubic splines were fitted for change in RKF over 6 months after initiating hemodialysis. Results: Among 39,623 patients with data on baseline renal CLurea and urine volume, there was a significant trend toward a higher mortality risk across lower RKF levels, irrespective of cause of death in a case-mix adjustment model (Ptrend < 0.05). Adjustment for ultrafiltration rate (UFR) slightly attenuated the association between low renal CLurea and high cause-specific mortality, whereas adjustment for highest potassium did not have substantial effect. Among 12,169 patients with data on change in RKF, a 6-month decline in renal CLurea showed graded associations with SCD, non-SCD CVD, and non-CVD risk, whereas the graded associations between faster 6-month decline in urine output and higher death risk were clear only for SCD and non-CVD. Conclusion: Lower RKF and loss of RKF were associated with higher cause-specific mortality among patients initiating thrice-weekly in-center hemodialysis.

    DOI: 10.1016/j.ekir.2023.07.020

    Web of Science



  2. Relationship between peak aortic jet velocity and progression of aortic stenosis in patients undergoing hemodialysis Reviewed

    Kurasawa S., Imaizumi T., Kondo T., Hishida M., Okazaki M., Nishibori N., Takeda Y., Kasuga H., Maruyama S.

    International Journal of Cardiology   Vol. 402   page: 131822   2024.5

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    Language:English   Publishing type:Research paper (scientific journal)  

    Background: The natural history of aortic stenosis (AS) progression, especially before severe AS development, is not well documented. We aimed to investigate the time course of peak aortic jet velocity (Vmax) and AS progression risk according to baseline Vmax, particularly whether there is a Vmax threshold. Methods: In a retrospective multicenter cohort study of patients on hemodialysis with aortic valve calcification, we investigated the time series of Vmax and the relationship between the baseline Vmax and progression to severe AS by analyzing longitudinal echocardiographic data. Results: Among 758 included patients (mean age, 71 years; 65% male), patients with Vmax <1.5, 1.5–1.9, 2.0–2.4, 2.5–2.9, and 3.0–3.9 m/s were 395 (52%), 216 (29%), 85 (11%), 39 (5.1%), and 23 (3.0%), respectively. The Vmax slope was gradual (mean 0.05–0.07 m/s/year) at Vmax <2 m/s, but steeper (mean 0.13–0.21 m/s/year) at Vmax ≥2 m/s. During a median 3.2-year follow-up, 52 (6.9%) patients developed severe AS. While patients with Vmax <2 m/s rarely developed severe AS, the risk of those with Vmax ≥2 m/s increased remarkably with an increasing baseline Vmax; the adjusted incidence rates in patients with Vmax <1.5, 1.5–1.9, 2.0–2.4, 2.5–2.9, and 3.0–3.9 m/s were 0.59, 0.57, 4.25, 13.8, and 56.1 per 100 person-years, respectively; the adjusted hazard ratio per 0.2 m/s increase in the baseline Vmax was 1.49 (95% confidence interval: 1.32–1.68) when Vmax ≥2 m/s. Conclusions: The risk of progression to severe AS increased with the baseline Vmax primarily at ≥2 m/s; a Vmax threshold of 2 m/s was observed.

    DOI: 10.1016/j.ijcard.2024.131822



  3. Association between stopping renin-angiotensin system inhibitors immediately before hemodialysis initiation and subsequent cardiovascular events

    Nakamura Y., Inaguma D., Imaizumi T., Kurasawa S., Hishida M., Okazaki M., Fujishima Y., Nishibori N., Suzuki K., Takeda Y., Maruyama S.

    Hypertension Research     2024

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    Language:English   Publisher:Hypertension Research  

    It is controversial whether renin-angiotensin system inhibitors (RASIs) should be stopped in patients with advanced chronic kidney disease (CKD). Recently, it was reported that stopping RASIs in advanced CKD was associated with increased mortality and cardiovascular (CV) events; however, it remains unclear whether stopping RASIs before dialysis initiation affects clinical outcomes after dialysis, which this study aimed to evaluate. In this multicenter prospective cohort study in Japan, we included 717 patients (mean age, 67 years; 68% male) who had a nephrology care duration ≥90 days, initiated hemodialysis, and used RASIs 3 months before hemodialysis initiation. The multivariable adjusted Cox models were used to compare mortality and CV event risk between 650 (91%) patients who continued RASIs until hemodialysis initiation and 67 (9.3%) patients who stopped RASIs. During a median follow-up period of 3.5 years, 170 (24%) patients died and 228 (32%) experienced CV events. Compared with continuing RASIs, stopping RASIs was unassociated with mortality (adjusted hazard ratio [aHR]: 0.82; 95% confidence interval [CI]: 0.50–1.34) but was associated with higher CV events (aHR: 1.59; 95% CI: 1.06–2.38). Subgroup analyses showed that the risk of stopping RASIs for CV events was particularly high in patients aged <75 years, with a significant interaction between stopping RASIs and age. This study revealed that patients who stopped RASIs immediately before dialysis initiation were associated with subsequent higher CV events. Active screening for CV disease may be especially beneficial for these patients. (Figure presented.).

    DOI: 10.1038/s41440-024-01616-8



  4. 特集 血液浄化法に応じた食と栄養 4.長時間血液透析(2)今日から実践可能な,透析患者の低栄養への根本的対策

    菱田 学, 岡崎 雅樹, 西堀 暢浩, 今泉 貴広, 金田 史香, 丸山 彰一

    臨床透析   Vol. 39 ( 12 ) page: 1397 - 1404   2023.11

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    DOI: 10.19020/cd.0000002767

    CiNii Research

  5. Number of calcified aortic valve leaflets: natural history and prognostic value in patients undergoing haemodialysis

    Kurasawa, S; Okazaki, M; Imaizumi, T; Kondo, T; Hishida, M; Nishibori, N; Takeda, Y; Kasuga, H; Maruyama, S

    EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING   Vol. 24 ( 7 ) page: 909 - 920   2023.6

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    Language:English   Publisher:European Heart Journal Cardiovascular Imaging  

    Aims: Aortic valve calcification in aortic sclerosis, a precursor of aortic stenosis (AS), is not always present in all three leaflets; how calcification develops in each leaflet is unknown. We aimed to investigate the natural history of calcification development in each aortic valve leaflet and the prognostic value of the number of calcified leaflets. Methods and results: In a retrospective multicentre cohort study of patients undergoing haemodialysis without AS, we observed calcification development in each aortic valve leaflet using echocardiography. We investigated the association between the number of calcified leaflets and AS development and mortality using time-to-event analysis. Among the 1507 patients (mean age, 66 years; 66% male) included in the longitudinal echocardiography analysis, 709 (47%) had aortic sclerosis at baseline: one-leaflet calcified, 370 (52%); two-leaflet calcified, 215 (30%); and three-leaflet calcified, 124 (17%). The median time for one calcified leaflet increase was 3-4 years, and 251 (17%) patients developed AS during a median 3.2-year follow-up. The increased number of calcified aortic valve leaflets was associated with developing AS; compared with that of one-leaflet calcified, the adjusted hazard ratios (aHRs) [95% confidence intervals (CIs)] of two- and three-leaflet calcified were 2.12 (1.49-3.00) and 4.43 (3.01-6.52), respectively; the aHR (95% CI) per one calcified leaflet increase was 2.24 (1.96-2.55). It was also associated with all-cause mortality; the aHR (95% CI) per one calcified leaflet increase was 1.18 (1.08-1.27). Conclusion: The number of calcified aortic valve leaflets strongly predicted AS development and even mortality in patients undergoing haemodialysis, suggesting the usefulness of assessing calcification for each valve leaflet separately using echocardiography.

    DOI: 10.1093/ehjci/jead020

    Web of Science