EDUCATION: March 1969: Graduated from the Jikei University School of Medicine

PROFECTIONAL EXPERIENCE:

• May 1969:  Resident at the Jikei University Hospital (Urology).
• November 1971: Resident at Kitasato University Hospital (Urology).
• April 1974: Researcher at Kitasato University School of Medicine.
• November 1974: Director of Kidney Center, Sagamidai Hospital, Invited Assistant Professor at Kitasato University School of Medicine (Urology, till 2018).
• September 1980: Director of Hashimoto Clinic (to present).

FIELDS OF SCIENTIFIC INTEREST: immunonephrology, onconephrology, thrombotic microangiopathies, monoclonal gammopathies of renal significance, and pregnancy-related kidney disorders.

CERTIFICATE:

• May 1969: Passed the National Examination for Medical Practitioners.
• 1988: Awarded the degree of Doctor of Medical Science from Kitasato University School of Medicine. Title: Production of beta 2 microglobulin in vivo and in vitro in maintenance dialysis patients

AREA OF STUDY:

• Complications in dialysis patients.
• Biocompatibility of dialysis membrane.
• On-line hemodiafiltration.
• Anemia, CKD-MBD, Psychonephrology.

MEMBERSHIP:

• The Japanese Society for Dialysis Therapy.
• The Japanese Society for Hemodiafiltration.
• Japanese Society of Nephrology.
• The Japanese Urological Association.
• Japanese Society for Artificial Organs.
• The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA).
• The American Society of Nephrology (ASN).

ABSTRACT

Title:  Current status of online hemodiafiltration in Japan

～ the role of alpha1-microglobulin ～

Hashimoto Clinic　Kenji Sakurai

At the end of 2021 there were 349,700 dialysis patients, while in 1968, the year JSDT was founded, there were only 215. Therefore, there were 1600 fold increase in the number of patients during this 53 year-period. Diabetic nephropathy became the main causative disease of ESRD since 1998 and CGN had been the leading cause until then.

HDF patients had been increasing year by year since 2012. At the end of 2021, 50.5% of the total number of dialysis patients were receiving HDF. 70.5% of HDF patients are receiving online HDF, and 28.3% are receiving I-HDF. Over 95% of on-line HDF in Japan are performed with the pre-dilution mode.

We have reported that in dialysis patients, Restless Legs Syndrome can be cured by continuous OL-HDF with a reduction rate of α1-microglobulin (A1M) of 40%, and that high-efficiency removal of A1M is also highly effective for the treatment of impaired joint mobility, arthralgia and other conditions associated with dialysis amyloidosis.

We could not determine why enhanced removal of A1M improves the symptoms associated with complications of dialysis therapy. However, in 2018, Kim proposed the following mechanism: These complications of dialysis therapy are caused by chronic microinflammation, and inflammatory cytokines, reactive oxygen species and other substances act on one another at the sites of inflammation; and the antioxidant A1M acts at these sites to eliminate reactive oxygen species and break the vicious cycle of inflammation, resulting in the resolution of symptoms. Since then, A1M has been understood not only as a biomarker of the removal efficiency of large molecules, but also as a functional molecule that plays an important role in dialysis therapy.