{"created":"2021-03-01T06:09:43.694276+00:00","id":5853,"links":{},"metadata":{"_buckets":{"deposit":"e0828419-8d33-49cb-a60f-d99933236492"},"_deposit":{"id":"5853","owners":[],"pid":{"revision_id":0,"type":"depid","value":"5853"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00005853","sets":["453:455","471:561:562"]},"item_6_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017-03-23","bibliographicIssueDateType":"Issued"},"bibliographic_titles":[{}]}]},"item_6_date_granted_51":{"attribute_name":"学位授与年月日","attribute_value_mlt":[{"subitem_dategranted":"2017-03-23"}]},"item_6_degree_grantor_49":{"attribute_name":"学位授与機関","attribute_value_mlt":[{"subitem_degreegrantor":[{"subitem_degreegrantor_name":"新潟大学"}]}]},"item_6_degree_name_48":{"attribute_name":"学位名","attribute_value_mlt":[{"subitem_degreename":"博士（医学）"}]},"item_6_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【背景】慢性腎臓病（CKD）は全身性のミネラル代謝異常を合併し, その結果骨や心血管に異常を呈して様々な病的状態を引き起こす. 副甲状腺機能異常など骨ミネラル代謝異常は腎移植後の移植腎, 特に尿細管腔内石灰沈着に影響する可能性がある.\\n【目的】移植腎にみられる尿細管腔内石灰沈着と移植前の諸因子, 特にミネラル代謝状況の関係を明らかにし, その臨床的意義を考察した.\\n【方法】新潟大学医歯学総合病院で腎移植を受けた成人慢性腎臓病患者のうち, 1）移植直後の腎生検で石灰沈着がない, 2）移植後4 週間の時点で移植腎のプロトコール生検を行った, 3）手術直前にカルシウム, リン, インタクト副甲状腺ホルモン（intact PTH）の血中濃度を確認した症例に対し症例対照観察研究を行った. 腎移植4週間後の腎生検で確認された尿細管腔内石灰沈着, 標準イヌリンクリアランス法による移植腎機能の関連を評価した. 背景因子と移植腎尿細管腔石灰沈着病変の関連を求めるために多変量解析を適用した.\\n【結果】検討対象116 人のうち23 人（19.8 ％）に移植腎尿細管腔内石灰沈着を認めた. 石灰沈着のあった群はなかった群に比べてイヌリンクリアランス値が有意に低かった[40.0（33.0 − 45.3）vs 49.5（37.0 − 57.8）mL/min, p ＝ 0.04]. 石灰沈着を認めた群のintact PTH 値は二峰性を示し,\\n120 ≦ intact PTH ≦ 540 pg/mL の範囲内にある症例の石灰沈着の出現が9.7 ％であったのに対\\nし, この範囲を上回る症例では46.2 ％, 下回る症例でも32.3 ％と明らかに高いことが判明した.\\n【結語】腎移植術前のPTH レベルの異常は, 移植腎尿細管腔内石灰沈着に関連し, しかも尿細管腔内石灰沈着は移植腎機能低下と関連する要因であった. 腎移植を視野に入れた慢性腎臓病患者の管理において, PTH は単に抑制するだけでなく, 生理的な域内に管理するべきである.","subitem_description_type":"Abstract"}]},"item_6_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"学位の種類: 博士（医学）. 報告番号: 甲第4265号. 学位記番号: 新大院博（医）甲第743号. 学位授与年月日: 平成29年3月23日","subitem_description_type":"Other"},{"subitem_description":"新潟医学会雑誌 130(12), 691-698, 2016-12","subitem_description_type":"Other"}]},"item_6_description_53":{"attribute_name":"学位記番号","attribute_value_mlt":[{"subitem_description":"新大院博（医）甲第743号","subitem_description_type":"Other"}]},"item_6_dissertation_number_52":{"attribute_name":"学位授与番号","attribute_value_mlt":[{"subitem_dissertationnumber":"13101甲第4265号"}]},"item_6_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟大学"}]},"item_6_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"ETD"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"河野, 恵美子"}],"nameIdentifiers":[{"nameIdentifier":"50986","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-05"}],"displaytype":"detail","filename":"h28nmk743.pdf","filesize":[{"value":"411.7 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"本文","url":"https://niigata-u.repo.nii.ac.jp/record/5853/files/h28nmk743.pdf"},"version_id":"cfdaf134-773a-4a90-bcc3-0d03623a3381"},{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-05"}],"displaytype":"detail","filename":"h28nmk743_a.pdf","filesize":[{"value":"193.2 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"要旨","url":"https://niigata-u.repo.nii.ac.jp/record/5853/files/h28nmk743_a.pdf"},"version_id":"cc7a5ab2-9976-44c0-b7e3-8c6aba57d7ee"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"腎移植","subitem_subject_scheme":"Other"},{"subitem_subject":"尿細管腔内石灰沈着","subitem_subject_scheme":"Other"},{"subitem_subject":"副甲状腺機能","subitem_subject_scheme":"Other"},{"subitem_subject":"イヌリンクリアランス","subitem_subject_scheme":"Other"},{"subitem_subject":"慢性腎臓病","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"thesis","resourceuri":"http://purl.org/coar/resource_type/c_46ec"}]},"item_title":"腎移植前副甲状腺ホルモン値の異常は移植腎の尿細管腔内石灰沈着に関連する.","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"腎移植前副甲状腺ホルモン値の異常は移植腎の尿細管腔内石灰沈着に関連する."},{"subitem_title":"腎移植前副甲状腺ホルモン値の異常は移植腎の尿細管腔内石灰沈着に関連する.","subitem_title_language":"en"}]},"item_type_id":"6","owner":"1","path":["455","562"],"pubdate":{"attribute_name":"公開日","attribute_value":"2017-06-12"},"publish_date":"2017-06-12","publish_status":"0","recid":"5853","relation_version_is_last":true,"title":["腎移植前副甲状腺ホルモン値の異常は移植腎の尿細管腔内石灰沈着に関連する."],"weko_creator_id":"1","weko_shared_id":2},"updated":"2022-12-15T03:39:06.905591+00:00"}