close
1.

論文(リポジトリ)

論文(リポジトリ)
柄澤, 良 ; 鈴木, 芳樹 ; 笠井, 昭男 ; 阪田, 郁 ; 成田, 一衛 ; 荒川, 正昭
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  112  pp.602-606,  1998-10.  新潟医学会
本文リンク: http://hdl.handle.net/10191/46253
概要: The number of diabetic patients suffering from end stage renal disease is increasing year by year. It is important to pr event and postpone the initiation and progression of diabetic nephropathy (DN). The purpose of this review is to discuss preventive treatment in the field of DN. The target of glycemic control is reported such as below 7.2 % and 6.5 % in serum HbA1c level in IDDM and NIDDM patients, respectively. Since it is difficult to achieve these targets, aldose reductase inhibitor, protein kinase C-β inhibitor and other drugs such as aminoguanidine may be a treatment which can compensate incomplete glycemic control. Concerning to glomerular hyperfiltration, ACE inhibitor (ACEI) is more beneficial among antihypertensive agents. Since recommended target level of blood pressure (BP) is below 130/85 mmHg (JNC VI), it is difficult to control BP using only ACEI, and then combination with other antihypertensive drugs will be necessary in many cases. The preventive effects of dietary protein restriction in the progeression of DN will be proven by prospective controlled multicenter-study. Administration of prostaglandin (PG) E1, PGI2, and pancreatic elastase (PE) induce the reduction of urinary albumin excretion rate (UAER) in some patients with DN. Long term effect of these agents remains to be investigated. Glycosaminoglycans (GAGs) including heparin is reported to reduce UAER in human and animal models of DN. GAGs with low anticoagulation action is necessary for clinical use. Concerning the clinical stage of DN, therapeutic approach to DN is summarized. 続きを見る
2.

論文(リポジトリ)

論文(リポジトリ)
上野, 光博 ; 荒川, 正昭
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  107  pp.490-496,  1993-06.  新潟医学会
本文リンク: http://hdl.handle.net/10191/37454
概要: Intrarenal vascular lesions of diabetic glomerulosclerosis were evaluated in order to clarify the relationship between vascular lesions and diabetic nephropathy in 108 NIDDM patients. Index of arteriolar hyalinous change (IAHC), designed as grade of AHC, was correlated significantly with age at biopsy, DM duration, GFR, PSP (15'), urine protein, systolic blood pressure (BP) and index of glomerular lesion (IGL). IAHC was also higher in hypertensive patients than in normotensive patients. Intimal thickening of small arteries (IT/SA) had a significant correlation with DM duration, systolic BP, GFR and Fishberg's concentration test. IAHC and IGL were significantly higher in IT/SA (+) group than in IT/SA (-) group. Intimal thickening of arteries (IT/A) was not related with clinical findings, although IAHC was significantly higher in IT/A (+) group. In conclusion, arteriolar hyalinosis may be closely related to the progression of diabetic nephropathy and intimal thickening of small arteries and arteries may contribute as well. 続きを見る
3.

論文(リポジトリ)

論文(リポジトリ)
荒川, 正昭 ; 甲田, 豊 ; 丸山, 雄一郎 ; 荻野, 宗次郎 ; 西, 慎一
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  102  pp.323-326,  1988-06.  新潟医学会
本文リンク: http://hdl.handle.net/10191/40787
概要: Nodular and diffuse glomerulosclerosis are two major glomerular lesions in diabetic nephropathy. The diffuse lesion appears from 1 to 6 years after the onset of diabetes. It consists of dense, homogenous and PAS-positive substance in the mesangium, of which the area is expanding year by year. The nodular lesion consisting of dense and PAS-positive substance is noticed several years after the appearance of diffuse lesions. The electron microscopy revealed lucent and edematous matrix connecting with subendothelial space in diffuse and nodular lesions, which may be compatible with mesangiolysis. Circumferential mesangial interposition, plasma insudation and monocyte infiltration are noticed rather frequently in the subendothelial space. Thinning of the basement membrane is also present, which is associated with rupture and microballooning. These active pathological processes may play some roles in the formation of nodular lesions. 続きを見る
4.

論文(リポジトリ)

論文(リポジトリ)
二宮, 裕 ; 阿部, 昌洋 ; 荒川, 正昭
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  102  pp.327-330,  1988-06.  新潟医学会
本文リンク: http://hdl.handle.net/10191/40788
概要: Pathophysiologic and clinical manifestations of kidney damage are duration related in diabetic patients. They appear according to a well-described sequence beginning with glomerular hyperfiltration and reversible proteinuria, progressing through fixed massive proteinuria (nephrotic syndrome), and ending in renal insufficiency. Over the past decade, uremia complicating diabetic nephropathy has emerged as the second prevalent cause of renal failure treated by maintenance hemodialysis. What makes the high prevalence of diabetic nephropathy so important is that the outcome of uremia therapy is generally unsatisfactory as measured by survival rate. In this session, some of current treatments for diabetic nephropathy are described. 続きを見る