Centers & Services

Nephrology, Diabetology and Endocrinology Department

What are Nephrology, Diabetology and Endocrinology?

We provide treatment for kidney disease, renal failure, diabetes, dyslipidemia, obesity, endocrine disease, hypertension, and other illnesses as well as prevention and treatment for chronic kidney disease and lifestyle disease/common disease.

Our physicians

Director, Department of Nephrology, Diabetes and Endocrinology

Jun Wada, Professor
[Diabetes, kidney disease, dyslipidemia and obesity]

Staff

Kenichi Shikata Professor (Center for Innovative Clinical Medicine) [Diabetes, kidney disease and metabolic syndrome]
Kenei Sada Associate professor [Rheumatic disease and kidney disease]
Kenichi Inagaki Associate professor (Endocrine Center) [Endocrine and thyroid disease]
Shinji Kitamura Lecturer [Kidney disease]
Ken Kinomura Lecturer (Hemodialysis and Apheresis Unit) [Kidney disease and dialysis]
Jun Eguchi Lecturer [Diabetes, dyslipidemia and obesity]
Atsuko Nakatsuka Assistant Professor [Diabetes, dyslipidemia and obesity]
Tomoko Kawabata Assistant Professor [Rheumatic disease]
Haruhito Uchida Associate Professor (Chronic kidney disease (CKD) Chronic vascular disease (CVD) area cooperation, Medical School Department of Chronic kidney Disease and Cardiovascular Disease) [Hypertension, arteriosclerosis, kidney disease, dyslipidemia and obesity]
Atsuhito Tone Assistant Professor (Diabetes Center) [Diabetes]
Satoshi Miyamoto Assistant Professor (Center for Innovative Clinical Medicine) [Diabetes]
Hiroshi Morinaga Assistant Professor (Medical Information Unit) [Kidney disease, CAPD and dialysis]
Katsuyuki Tanabe Assistant Professor (Hemodialysis and Apheresis Unit) [Kidney disease and dialysis]
Naoko Yamauchi Assistant Professor (Endocrine Center) [Endocrine and thyroid disease]
Masashi Kitagawa Assistant Professor [Kidney disease and dialysis]
Haruki Watanabe Assistant Professor [Rheumatic disease]
Kishio Toma Assistant Professor [Endocrine and thyroid disease]
Toshio Yamanari Assistant Professor [Kidney disease, CAPD and dialysis]
Yoshinori Matsumoto Assistant Professor [Rheumatic disease]

Department of Human Resource Development of Dialysis Therapy for Kidney Disease (HDAK)

Hitoshi Sugiyama Professor [Kidney disease and CAPD]
Akifumi Onishi Assistant Professor [Kidney disease, CAPD and dialysis]

Medical School Department of Primary Care and Medical Education

Sanae Teshigawara Assistant Professor [Diabetes]

*Specialty shown in [ ]

Weekly schedule of outpatient clinic

  Monday Tuseday Wednesday Thursday Friday
Clinical sections available by day of the week AM
PM
Internal Medicine, Kidney Disease, Diabetes, Rheumatic Disease, Hypertension, Arteriosclerosis, Endocrine and Thyroid Disease
    Renal failure / CAPD Detailed CKD examination Renal failure / CAPD Detailed CKD examination

Treatment system

Outpatient special care of the Department of Nephrology, Diabetology and Endocrinology is available in the morning and afternoon from Monday through Friday, providing treatment by the specialists of respective fields.
We also actively address regional medical cooperation. The specialists and doctors of respective fields are also in charge of inpatient care. Endocrinology care is provided as the Endocrine Center in collaboration with the Department of Endocrinological Surgery, etc. Moreover, the outpatient diabetes care program provides meticulous care through the collaboration of diabetes specialists and diabetes educators. The diabetes education is held as inpatient care under the team medical care system.

Treatment policy

The treatment policy for inpatients is discussed and determined in the new patient conference and the professor's round, which are held every week with the participation of doctors and full-time doctors including assistant professors and above. Moreover, each case is discussed in detail by the specialized group of respective fields in a conference for the determination of definitive diagnosis and treatment policy. In addition, the Department of Diabetology emphasizes educational hospitalization and performs detailed examination for microangiopathy and arteriosclerosis for early detection and treatment.

Specialties

Diagnosis and state-of-the-art treatment are provided for kidney diseases such as nephritis, nephrotic syndrome and renal failure, introduction of hemodialysis, introduction of peritoneal dialysis, and support in outpatient care.
Lifestyle guidance and drug therapy are provided for metabolic diseases such as diabetes, dyslipidemia, obesity,and metabolic syndrome. Research is conducted to explore the pathogenic and progress mechanisms of diabetic nephropathy: cause-oriented treatment.
Detailed examination and treatment are provided for endocrine diseases affecting the hypothalamus, pituitary gland, thyroid, parathyroid gland, adrenal gland and gonads, and related organs.

Scope of target diseases

Acute nephritis, chronic nephritis (such as IgA nephropathy), nephrotic syndrome, rapidly progressive nephritis, acute renal failure, chronic renal failure, type 1 diabetes, type 2 diabetes, obesity, hyperlipidemia, hypertension,arteriosclerosis, hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoparathyroidism, pheochromocytoma, primary aldosteronism, Cushing's syndrome, diabetes insipidus, etc.

Description of medical care

The Department of Nephrology, Diabetology and Endocrinology and the Department of Rheumatology provide specialized care mainly for diabetes, hyperlipidemia, kidney disease, hypertension, rheumatic disease, and endocrine disease. For refractory kidney disease and rheumatic disease that are resistant to existing therapies, we endeavor to improve clinical outcomes using state-of-the-art treatment methods such as blood purification and immunosuppressive therapy. We also specifically examine preventive medicine for lifestyle diseases (such as diabetes, hyperlipidemia and hypertension), which constitute a severe public problem.
Among metabolic diseases, comprehensive care is provided for diabetes, metabolic syndrome and dyslipidemia, which have been increasing considerably in terms of the number of patients. Our diabetes care has an established reputation in diabetes care support in close cooperation with the nursing division, pharmacists and nutritionists, strict blood sugar control (improvement in glucotoxicity) by intensive insulin therapy, early detection and preventive treatment of complications such as nephropathy, and evaluation of insulin resistance by glucose clamp.
For kidney disease, we endeavor to conduct accurate diagnoses and appropriate treatment by kidney biopsy findings for widely diverse diseases that show glomerulonephritis, nephrotic syndrome, and chronic renal failure. Therapeutic effects have been achieved in patients with nephritis that is refractory, frequently recurrent, or with severe complications by the concomitant use of immunosuppressive therapy and LDL apheresis. For patients with renal failure, renal function is maintained in the conservative period by treatment including diet therapy and blood pressure control. Appropriate care and patient education are provided by specialized staff for the introduction of dialysis (peritoneal dialysis and hemodialysis).
As for rheumatic disease, about 1000 patients are visiting us for treatment of rheumatoid arthritis, systemic lupus erythematosus, vasculitis and related diseases. We have a history of practice ahead of other medical institutions and a wealth of experience in immunosuppressive therapy, biological products, plasmapheresis and immunoadsorption therapy for patients with collagen disease that are severe, refractory and with complications in addition to typical cases. Moreover, we currently provide treatment for about 40 kinds of rheumatic disease. Moreover, we endeavor to achieve early detection and early treatment based on that experience.
For endocrine disease, diagnosis is made comprehensively by endocrine tests, diagnostic imaging, and genetic tests, and other methods. Care is provided in collaboration with surgeons through collaboration with the Endocrine Center. For thyroid disease, we play our role as a central specialized medical institution of the community, providing treatment regularly for nearly 200 patients.

For outpatient visits

For revisiting outpatients

  • How to make an appointment: Your appointment is registered in the PC at the end of consultation.
  • Appointment time frame: The time frame is written on the revisit appointment sheet.

Highly advanced/special medical treatments

Main methods for testing and explanation

Highly advanced medical treatments

  • Kidney / Kidney biopsy: These are performed during the hospital stay for diagnosis of kidney disease that causes abnormal urinalysis results and renal dysfunction, and to determine the treatment policy.
  • Diabetes / Continuous glucose monitoring system (CGMS): Accurate blood sugar control is performed by the continuous monitoring of blood glucose. Continuous subcutaneous insulin infusion (CSII): In this treatment method, insulin is infused continuously with an insulin pump.
  • Endocrine / Endocrine loading test: Thyroid ultrasonography and thyroid aspiration cytology

Main testing methods and medical equipment

Diabetes education

The diabetes education for diabetes patients is held every day from Monday through Friday by the staff specialized in diabetes care including doctors, nurses, pharmacists, registered dietitians, physical therapists, medical technologists, dentists, and dental hygienists. The class is designed to provide a better understanding of diabetes through easy and specific explanations using pamphlets and slides, and to support diabetes treatment for patients.

Kidney biopsy

Kidney biopsy is the most important testing method in the diagnosis and treatment of kidney disease, and is performed in 150 cases annually. Our department is a pioneer institution to perform kidney biopsy in Japan.
Kidney biopsy has been established as a safe and reliable diagnostic method along with improvement in devices. Skilled doctors collect kidney tissue under the guidance of ultrasound to be subjected to microscopy of differently stained samples, immunofluorescence and electron microscopy, and comprehensive diagnosis based on the resulting observations. Relations between detailed histological evaluation and long-term prognosis are followed up so that the results will be fed back to the long-term treatment of individual patients. Hospital stays of about a week are necessary to avoid and mitigate postoperative complications.

Comprehensive and detailed examinations for kidney disease

Testing including laboratory tests, immunology, urine protein assay (24-hour urine collection), clearance, diagnostic kidney imaging (such as ultrasonography and CT) and molecular biology in addition to kidney biopsy are performed to assess the patient's overall pathological condition and to gain information that can be used to formulate a therapeutic strategy for the patient.

Hemodialysis and Apheresis Unit

We provide specialized care to perform emergency hemodialysis safely for rapidly progressive glomerulonephritis and acute renal failure, and to introduce hemodialysis for chronic renal failure with complications. Plasma exchange, double filtration plasmapheresis, immunoadsorption therapy, and lymphocytapheresis are performed for refractory collagen disease and neurological diseases, and LDL apheresis is performed for refractory nephrotic syndrome.

Continuous ambulatory peritoneal dialysis (CAPD)

The CAPD treatment method presents benefits as a maintenance therapy for chronic renal failure that contrast with those of existing hemodialysis. Our department provides education and training for the introduction and maintenance of CAPD as home therapy that can be performed under the control of the renal failure patient.
Immunological testing
Tests of antinuclear antibodies, autoantibodies and complements are important for the diagnosis and treatment of collagen disease and rheumatic disease. For example, antineutrophil cytoplasmic antibody has recently been used for the diagnosis, classification, and treatment of vasculitic syndrome, although we performed the test earlier in our medical school department. Various specialized immunological tests like this are available.
However, we endeavor to use diagnostic imaging, endoscopy and biopsy, and other methods with the aim of establishing a treatment method to assess the pathological condition of lung lesions that affect the prognosis of collagen disease.

Endocrine testing

Pituitary function testing and adrenal function testing, endocrine organ diagnostic imaging (MRI, CT and scintigraphy), thyroid ultrasonography and guided cytology testing are performed. Moreover, comprehensive diagnoses of various endocrine diseases are performed by specialists of endocrine metabolism. In addition, measurement of pressor hormones and 24-hour ambulatory blood pressure monitoring (ABPM) for hypertension patients are also available. These are used for the differential diagnosis of secondary hypertension as well as in the pathological condition analysis of and selection of appropriate therapeutic drugs for hypertension.


  •  
  • Hemodialysis and Apheresis Unit
    Hemodialysis and Apheresis Unit
  • Endocrine Center Conferencep
    Endocrine Center Conferencep