| 特集名 | 透析スタッフに必要な腎移植医療の知識2013 | |
|---|---|---|
| 題名 | 腎移植後の生活習慣病 | |
| 発刊年月 | 2013年 08月 | |
| 著者 | 中村 道郎 | 東海大学医学部外科学系移植外科学 |
| 著者 | 角田 隆俊 | 東海大学医学部内科学系腎内分泌代謝内科学 |
| 【 要旨 】 | 腎移植患者においても，生活習慣病のさまざまな要因と密接に関連しているメタボリック症候群は，大きな問題となっている．腎移植後に合併するメタボリック症候群は，移植腎機能の悪化や，心血管病を引き起こす可能性がある．腎移植後，生活の質の改善がみられるが，投与されるステロイド剤によって，内臓脂肪が蓄積しやすくなる．さらにカルシニューリン阻害薬はステロイド剤とともに，メタボリック症候群のその他の要因，すなわち高血圧，脂質代謝異常，耐糖能異常などに悪影響を与える． メタボリック症候群を防ぐ目的で，最近はステロイド剤を減量・中止するレジメンが行われている．腎移植患者の，薬物療法を含めた管理や治療方針については，2011年に日本臨床腎移植学会が提案した『腎移植後内科・小児科系合併症の診療ガイドライン』に詳述されている． |
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| Theme | Necessary kidney transplant knowledge for the dialysis staff, 2013 | |
|---|---|---|
| Title | Lifestyle-related diseases in kidney transplant recipients | |
| Author | Michio Nakamura | Department of Transplant Surgery, Tokai University School of Medicine |
| Author | Takatoshi Kakuta | Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine |
| [ Summary ] | Metabolic syndrome in kidney transplant recipients is a growing concern worldwide. It is closely associated with lifestyle factors, which cause lifestyle-related diseases. There is ample evidence proving an association between this syndrome and cardiovascular disease, as well as chronic kidney disease. Moreover, this syndrome is likely to lead to deterioration of transplant graft function. Visceral obesity may be exacerbated by quality of life alterations and adverse effects due to steroidal agents after kidney transplantation. Steroidal agents and calcineurin inhibitors give rise to negative impacts on other factors related to this syndrome, such as hypertension, hyperlipidemia and glucose tolerance impairment. Recently, steroid withdrawal and minimization regimens have become more common to reduce the prevalence of metabolic syndrome. Other strategies concerning transplant patient care, including various drug therapies, are detailed in "The Clinical Guideline for Medical and Pediatric Complications after Kidney Transplantation" released by the Japanese Society for Clinical Renal Transplantation in 2011. |
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