| Project/Area Number |
26461117
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Cardiovascular medicine
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| Research Institution | Toho University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
長谷 弘記 東邦大学, 医学部, 教授 (90180851)
田中 友里 東邦大学, 医学部, 講師 (30385794)
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| Project Period (FY) |
2014-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2018: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2017: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2016: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2015: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2014: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
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| Keywords | 肺高血圧 / 末期腎臓病 / α-Klotho / FGF23 / バスキュラーアクセス / 血液透析 / 肺動脈圧 / Ca/P代謝異常 / αKlotho / 慢性腎臓病 / 肺高血圧症 / 動静脈シャント |
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| Outline of Final Research Achievements |
The prospective longitudinal observational study planned and conducted to clarify the prevalence of pulmonary hypertension (PH) in end-stage kidney disease (ESKD) patients, and to identify the potential contributor to uremic specific PH. On the baseline data, about 25% of 17 ESKD patients was suffered from PH which is defined as the patients with mean pulmonary artery pressure (PAP) over 30mmHg by echocardiogram at the creation of arteriovenous (AV) fistula. Interestingly significant inverse association was found between PAP and serum alfa-klotho which is one of the factors for underlying the degenerative processes seen in chronic kidney disease. There were no good correlation between PAP and the other factors such as serum endothelin, pentraxin3, and FGF23. In the longitudinal study, PAP did not show any remarkable change after creation of AV fistula and starting hemodialysis (HD). However, decreasing of alpha-klotho may play at least in part for developing uremic specific PH.
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| Academic Significance and Societal Importance of the Research Achievements |
高率に合併する末期腎臓病患者の肺高血圧症は依然としてその病態は解明されていない。近年、末期腎臓病患者の死因の主因が心臓突然死であることが報告され始め、肺高血圧症との関連が指摘され始めている。本研究では、動静脈吻合の影響や血液透析療法自体の肺動脈圧への影響は、予想に反して認められなかった。一方で、慢性腎臓病の退化、早老現象と深くかかわる事が知られているα-Klothoと肺動脈圧が負の関連を示したことは非常に興味深い。保存期腎臓病からのα-Klothoを減少させない加療に、肺高血圧予防の道が開けるかもしれない。
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