Keizo Koide

Experimental and clinical study on the lymph circulation

Abstract 1. 1. Molecular weight, shape, and electric charge may each play some role in determining the rate of disappearance of macromolecules from subcutaneous connective tissue. 2. 2. The state of the connective tissue, especially the volume and state of its ground substance, may modify the rate of disappearance of macromolecules from the tissue. 3. 3. There are at least three types of edema: tissue clearance of albumin was slow in lymphedema, normal in myxedema, and accelerated in other types of edema. The clearance rate was usually normal in scleroderma and rapid in hyperthyroidism and in edema of lymphosarcomatosis. 4. 4. The rate of clearance of albumin from subcutaneous tissue can be used as an indicator of lymphatic flow under usual conditions.

Prognostic Factors for a Composite End‐Point of Renal Outcomes in Patients With Chronic Kidney Disease

Abstract:  We aimed to investigate prognostic factors for a composite end‐point of end‐stage renal disease (ESRD) and the progression of renal disease in Japanese patients with chronic renal disease. Using a composite end‐point comprising a doubling of serum creatinine (sCr), an increase in sCr level to 6.0 mg/dL, or initiation of dialysis and renal transplantation caused by ESRD, we examined data obtained in a prospective cohort study. The present study consisted of 641 patients who were 20 years of age or older with chronic renal disease caused by diabetic nephropathy, glomerulonephritis, or nephrosclerosis, and who had baseline sCr levels of 5.0 mg/dL or less. The following criteria were examined as prognostic factors: sex; age; elapsed time from initial diagnosis; disease underlying the nephropathy (diabetic or non‐diabetic); complications with hypertension, hyperlipidemia, or anemia; baseline sCr level; therapeutic regimen, including use of ACE inhibitors or Ca2+‐channel blockers; and diet. A log‐rank test was used for univariate analysis, and Cox regression analysis was used for multivariate analysis. Underlying disease (diabetic or non‐diabetic), baseline sCr level, and Ca2+‐channel blocker therapy were significantly related to event incidence. In the present study, we identified underlying disease and baseline sCr level as important prognostic factors for a composite end‐point in a predialysis patient population in both the early and middle stages of renal disease. These factors should be considered as balancing variables for randomization in future clinical studies.