JSN NEWS
JSN NEWS 2005
● Obituary : We lost two honorable members this year.
Dr. J Ohno who was a professor emeritus of the Juntendo University died on October 21. He served as a president of the 24th annual JSN scientific meeting. Dr S Tohjo who was a professor emeritus of the University of Tsukuba died on November 12. He served as a president of the 27th annual JSN scientific meeting. Both of them were active as researcher and educator, and raised many fellows in this field of medicine. JSN express sincere thanks to them. And acknowledge their contribution to the society.
● Greeting from the JSN president Prof. F Gejyo As a president of the JSN, I would like to take this opportunity to thank all of the members of JSN, house-staff, and those who have interested and supported our activities. I succeeded this honorable position on 2004 from the former president, Dr. Y Asano; JSN has been faced for the rapid changes in environment surrounding the scientific association. This year, JSN moved to the new home and has better communication with the Japanese Society of Internal Medicine. The Japan chronic kidney disease initiatives (JCKDI) is working hard to publicize the hot issues of kidney disease and reported unexpectedly high prevalence of low GFR among the general screenees during the Japan Kidney Week (23 - 26 June 2005, Pacifico Yokohama). It is our goal to prevail the knowledge how to detect early and start treatment for those who might develop to end-stage renal disease. I sincerely hope you will have A Merry Christmas and A Happy New Year!
● Second JSN Nephrology Seminar for Trainees The Second JSN Seminar organized by the sub-committee was held on November 19 (Sat.) and 20 (Sun.) in Miyako Hotel, Naha, Okinawa. The number of attendee was 55. Half of them were under training in Okinawa. On Saturday evening, there was a workshop titled: Career building after finishing two years post-graduate training - what will be the better training program? Panelists were Drs. Toyoda, Motomura, Tokuda, Hayano, and Prof. Ichikawa. Guest commentator was Dr. F Miyasato. Dr. Miyasato was a former chief of Nephrology division at Okinawa Chubu Hospital and an experienced teacher and clinician. After the panel, there was a get-together party to communicate each other "Make 100 friends". Sunday morning program started at 7:30 with the lecture "Life-long research on the target genes for kidney disease" by Prof. Ichikawa. Then, attendees were grouped into small groups. Topics were 1) Renal failure: what will you do first? 2) Case study: what is your diagnosis? 3) Luncheon quiz: what kinds of fluid should be used? 4) Treatment of glomerulonephritis: what is your choice of treatment plan? Dr. Miyasato was also attended the Sunday session and contributed a lot stressing the importance of clinically oriented training. Attendees have responded to the questionnaires on this seminar, and the summary will be reported later. The sub-committee of pre- and postgraduate training in Nephrology (led by Professor H Imai), under the Committee of the Clinical Nephrology Board Examination (chaired by Professor A Koyama) is planning several activities on this important issue. Next year, other seminars will be held around Japan.
● The 17th Japan Diabetic Nephropathy Meeting
The 17th Japan Diabetic Nephropathy Meeting was held on Dec. 3 (Sat.) to Dec. 4 (Sun.) in Tokyo, and discussed broad area concerning DM nephropathy. DM nephropathy is the leading cause of end-stage renal disease in Japan and is a pandemic disease, in particular Asian countries. This meeting was organized by four key persons such as Prof. R Kikkawa, Dr. K Kaizu, Dr. N. Tajima, Prof. H. Makino, and Prof. S. Katayama. In this-year meeting, there were 29 oral presentations and one mini-symposium. Dr. T Takamoto spoke on "Coronary Microcirculation and Myocardial Damage in Diabetes" during the Luncheon-seminar. Prof. H Haller, Department of Nephrology, Medizinische Hochschule, gave two invited lectures on "Clinical Significance of ARB, Olmesartan, in Diabetes: From EUTOPIA to ROADMAP" and "Stem Cells and Regeneration of Renal Tissue". This meeting provided physicians with new insight and practical information that can be used in a clinical setting. The principle of bench to bedside can be put into practice via such meeting specialized on one category. Such conference may add an environment that encourages researchers, clinicians, and physicians to exchange knowledge, discuss clinically relevant information, and establish an active link between basic research and clinical applications.
● The 2005 Autumn JSN Executive Board Meeting The 2005 Autumn JSN Executive Board Meeting, chaired by Prof F Gejyo, was held on October 31, 2005, in Tokyo. The current number of the JSN member is 7,500. Among the scientific associations of subspecialty in internal medicine, this number is rather small, which is 11th from the top. It is also noteworthy that there are clear geographic differences in JSN members. Some prefectures are suffering from the scarcity of nephrologist. JSN need to act seriously on this disparity on specialist. JSN seminar for trainees, which could be one of the solution was started this year to recruit the members. However, financial issues for the future seminars remained to be discussed. Activities of each committee were reported, approved, and discussed as necessary. Among them, the planning and administration, led by Prof. A Hishida, which covers broad area of JSN activity, reported several important issues and approved by the executive board members. Program of the 49th JSN general scientific meeting, which will be held on June 14 to 16, 2006, Tokyo, is now under preparation by Prof. Higashihara. Plan of the 50-th JSN anniversary, led by Prof T Fujita, was reported and will be scheduled on September 7 to 8, 2007. The 2006 Spring Executive Board Meeting will be held on May 1, in Tokyo.
● News from the Public Relations (PR) Committee? Public relations committee, chaired by Prof. I Ishikawa, has been working hard to publicize the JSN activities. With the increasing demands for information and needs to communicate each other, PR committee is afraid that some JSN members might be suffering from the scarcity of contact directly from the JSN. PR committee decided to prepare the mailing list for all the voluntary members of JSN to strengthen the relationship between JSN members and JSN office. This list may facilitate the communication directly with the JSN office. Also, we believe such communication will improve the JSN activities and further increase the number of papers from the JSN members for the official JSN journals such as Jpn J Nephrology and CEN. Details on the application for this list will be officially publicized later on. With this list, we are able to collect ideas for improving JSN activities, information regarding the local activities, and distribute the JSN official events and others. In this context, the JSN council is also considering on promotion of local activities such as research communications and invited talks. For these purposes, PR committee is now planning to call for recommendation or self-recommendation of key-persons in each prefecture. Key-persons are expected to act voluntarily to cooperate with the PR committee as well as each regional JSN members. Those who have comments or good ideas on this plan, please contact with JSN, www.jsn.or.jp.
● Second JSN Nephrology Seminar for Trainees The Second JSN Seminar organized by the sub-committee will be held on November 19 (Sat.) and 20 (Sun.) in Miyako Hotel, Naha, Okinawa. The expected attendee will be 50 who will finish two years training next spring. Details of this seminar will be found in the home page in www.jsn.or.jp. In brief, Saturday evening, there will be a workshop titled: Career building after finishing two years post-graduate training - what will be the better training program? Panelists are Drs. Toyoda, Motomura, Tokuda, Hayano, and Prof. Ichikawa. Guest commentator is Dr. F Miyasato. After the panel, there will be a get-together party to communicate each other "Make 100 friends". Sunday morning program will start at 7:30 with the lecture "Life-long research on the target genes for kidney disease" by Prof. Ichikawa which he does the similar session at the Harvard University and MGH. Then, attendees are grouped into small groups. Topics are 1) Renal failure: what will you do first? 2) Case study: what is your diagnosis? 3) Luncheon quiz: what kinds of fluid should be used? 4) Treatment of glomerulonephritis: what is your choice of treatment plan? Eleven members of the task force are coming to Okinawa. The sub-committee of pre- and postgraduate training in Nephrology (led by Professor H Imai), under the Committee of the Clinical Nephrology Board Examination (chaired by Professor A Koyama) is planning several activities on this important issue.Next year, other seminars will be held around Japan.
● Japan Chronic Kidney Disease Initiatives (JCKDI) JCKDI consists of four working groups such as 1) epidemiology (sub-leader, Dr. E Imai), 2) guideline for CKD management (sub-leader, Dr. Y Iino), 3) planning and promotion (sub-leader, Dr. H Makino), and 4) liaison with international activities (sub-leader, Dr Y Tsukamoto). JCKDI management committee meeting was held on September 25 and set the goals for each working group. Unfortunately, precise formula to estimate GFR is not available for Japanese. MDRD formula has inherent problems when applied for Japanese. At the last Japan kidney week, Dr E Imai summarized the epidemiological studies concerning the prevalence of CKD in Japan. Surprisingly, it was far larger than expected and the distribution pattern of GFR was quite different from the U.S. population. Clinical significance of low GFR remains to be studied. So far, JSN has published several guidelines and booklets concerning kidney diseases, urine test, and renal failure. Given the high prevalence of patients on chronic dialysis therapy and CKD, more public relations are necessary. It would be mandatory to call attention from the public resources such as government, industry, scientific associations, and other non-government organizations. To promote effective strategies for the prevention or retarding the progression of CKD, JCKDI should take initiative to get together all candidate groups to establish the Panel for Japan CKD treatment. Proposal for the international symposium which will be held in accordance with the 50th anniversary of JSN scientific meeting was made and currently waiting for the approval from the coming JSN executive board meeting.
● Thanks Mr. Takashima Mr. T Takashima, chief of the JSN house staff, is leaving this October. He has been served for JSN since January, 1993. During his service, JSN faced several important events. First, JSN was legality approved as non-profit organization on 1994. He prepared many papers and negotiated with people outside JSN. Secondly, JSN office was originally settled in Nihon University on October 1959. On 1992, it moved to 7F Tendai-Building, Shinjyuku-Ku. He joined JSN at the newly moved office. Therefore, there should be many problems related to the changes in home address. Thirdly, JSN office has to move frequently for the past 10 years. It moved to 2F Kyobashi-Bldg, Chuo-Ku on December 2001. Four years later, JSN moved to 2F Nichinai-Kaikan, Bunkyo-Ku on August 2005. We all appreciate his skills for managements and polite character. It would be a great opportunity to cerebrate his last day for JSN, since many will get together for the autumn executive board meeting on October 31. Mr. I Nishizawa is working after him. He already joined JSN this August and worked with Mr. Takashima for transferring activities smoothly.
● JSN Eastern Regional Meeting JSN Eastern Regional Meeting was held on October 7 (Friday) to October 8 (Saturday) in Niigata. The convention venue was the Toki Messe Hall. Professor F. Shimizu, president of the meeting, put the slogan of the meeting: Perspectives in Nephrology – from bench to bedside. Professor W. Kriz, University of Heidelberg, gave a special lecture titled "The role of the podocyte in proteinuria and the progression of chronic renal disease". Professor G. Remuzzi, Mario Negri Institute for Pharmacological Research, who was scheduled to talk on the title of "The clinical meaning of proteinuria", could not come due to a sudden change of his situations. He prepared the video-lecture which was projected in the main hall. Professor K. Kurokawa, president of the Science Council of Japan gave an invited address on "Academic societies: Quo Vadis?" He insisted to reconstruct it at our own risk. Professor F. Shimizu had a presidential lecture titled "Role of experimental glomerulonephritis on further development of clinical nephrology". He summarized the past 40 years career of research on renal damage induced by immunological agents such as monoclonal antibodies and non-immunological mediators. He argued for the Masugi-nephritis as the prototype of experimental glomerulonephritis. The main symposium was titled "Clinical markers on severity of chronic kidney damage". There were four workshops and 7 lectures on recent topics. For the general session, there were 60 oral and 207 posters presented. Total number of attendees was approximately 1,100. There was a special program for students and trainees. Another one was for the comedicals - as the 14th dietary and lifestyle modification class. There was an additional educational program for renal biopsy specimen. Next meeting will be held in Yokohama, by Prof. Koitabashi.
● JSN Western Regional Meeting JSN Western Regional Meeting was held on September 30 (Friday) to October 1 (Saturday) in Nagasaki. The convention venue was the Nagasaki Brick Hal and the Nagasaki News Paper Cultural Hall. Professor T. Taguchi, president of the meeting, put the slogan of the meeting: Innovation in Nephrology –- From Nagasaki to the World. Two special lectures were Prof. N. Yamanaka and Dr. Burke-Gaffney BF. Titles of the speech were "Perspectives on Nephrology: A Pathologist View" and "History of western style medicine and Nagasaki". Professor T. Taguchi gave a presidential lecture titled "What we have learned from the biopsy specimen". The main symposium was titled "Lessons from the morphology in nephrology research". There were three workshops and two educational seminars. There were 5 lectures on recent topics. Also, there was a renal-biopsy-case conference. Prof. Y Iino and Dr. K Harada directed lectures for citizens on renal diseases. During the meeting, collection of Japanese old photographs in Bakumatsu-Meiji period was displayed. For the general session, there were 252 posters presented. Total number of attendees was 940. The meeting was very well organized and the attendees recognized the principle of the slogan. The message was clear that we have to contribute as Nephrologists for patients and people through the daily practice and original works on clinical and basic science. New knowledge and culture should be send from Nagasaki (Japan) to the world, and from the world to Nagasaki(Japan). Next meeting will be held in Kumamoto, Prof. K Tomita.
● Call for papers to CEN Clinical and Experimental Nephrology (CEN; Editor-in Chief, Professor F Shimizu) is the official journal of JSN. Currently, it is published quarterly and distributed to more than 7000 JSN members and some are sent to foreign colleagues. It is listed on the PubMed since 2004, vol 7, no. 1. Nine new members from abroad joined the editorial team. It consists of 5 categories: review article, original articles, case reports, letters to the Editor, and images in nephrology. Reputation of journal is simply dependent on the content of papers and the "impact factor (IF)" is one of the markers to compare the quality of journal. JSN members are encouraged to submit their best papers to the CEN and to cite CEN papers in other journals. Unfortunately, CEN has not got IF, yet. Abstracts at the general assembly or regional meeting (eastern and western) might be welcomed to send as full papers to CEN. JSN members should support our journal. Colleagues from Asian countries who attend JSN meetings may be targets to get readership. International session during the general JSN meeting is now a regular one, and the number of attendees from abroad is increasing. The number of scientific journal is increasing and the competition to get quality papers is fierce. CEN is now at the high time to change gear toward "major" journal. Editorial team is now working for the online submission.
● JSN Committee Secretary Report JSN Committee Secretary meeting was held on August 24. The main theme was how to facilitate the JSN scientific meetings and other related activities. There are many obstacles and rules inherent to JSN as other societies and communities in Japan. JSN is going to take initiatives on the general scientific meeting and the regional meetings both western and eastern. Selection criteria of the principal of each meeting should be clarified and the process should be open to the members. Those who are best and talented from the members should be selected and the JSN task force should be organized to support the related-activities. It might be necessary to call new-members or younger generations to join the team. For these purposes, JSN is planning to build the mailing-list for all the members to collect creative suggestions and opinions for JNS from the members. Other important issue is to vitalize the local nephrology services and recruit young doctors to Nephrology and JSN. One of the ideas is to give credit for local research meetings. There are many such meetings in each prefecture or regional unit. Criteria for the credit may need to be clarified to assure the quality and contents. In this summer, meetings of several JSN subcommittees are being held. They will propose several suggestions and plans to get the final approval at the autumn executive board meeting which will be held on October 31, 2005.
● First Summer School for Renal Pathology was held Renal pathology class was held on August 13 (Saturday) and 14 (Sunday) at Shinshu University, Matsumoto, Japan. There were 40 attendees from all around Japan. Opening remarks was given by Dr. Sugisaki. Prof. Makino introduced the activities and points about the guidelines of the standardization of renal biopsy (RBX) diagnosis. The first session was related to the basis of renal pathology: handling and staining of RBX specimen (Dr. Yamanaka), light microscopy (Dr. Taguchi), immunofluorescent (Dr. Ueda), and electron microscopy (Dr. Hamaguchi). The second session was related to the classification of glomerulonephritis (GN) combined with case presentation and observation of RBX specimens. Attendees were grouped into 8 groups with 5 in each group under the support of renal pathologists: IgA GN and HSP (Dr. Joh), membranous GN (Dr. Ueda), membranoproliferative GN (Dr. Hisano), and FSGS (Dr. Joh). After the class, there was a get-together party. On Sunday morning, Dr. Shigematsu gave a lecture titled: The standardization of renal pathological diagnosis: what to learn and how to read RBX? The fourth session was related to the secondary renal disease and done same as the second session: DM nephropathy (Dr. Kitamura), lupus nephritis (Dr. Nagata), followed by tubulointerstitial and vascular lesions (Dr. Ehara), graft biopsy and rejection (Dr. Yamaguchi). Attendees were given the certificate. Next summer school will be held in Sapporo. Details are to be announced.
● NKF International Medal for Dr Y Tsukamoto Good news for JSN members! Dr. Y Tsukamoto, Shuwa General Hospital, Saitama, was elected as a recipient for the coming National Kidney Foundation (NKF) International Medal. He is invited to the 2006 NKF Clinical Meeting in Chicago,IL,USA. The award will be presented on Friday, April 21 during the President's Dinner. Dr. Y Tsukamoto has been contributed as a member of KDIGO and is currently nominated as a member of board of directors. Obviously, this medal is for the recognition of his long-lasting contribution to the international nephrology community. Currently, he is an active member of the JCKDI and is playing an important role as an executive board member and a leader of working group of international liaison. Dr. Tsukamoto has many foreign friends including Dr. G Eknoyan, KDIGO president. JSN congratulate his ward and is expecting further contribution to JSN.
● The 1st Japan-China Kidney Conference The 1st Japan-China Kidney Conference was held on Oct 16 (Sat.), 2004 in Tokyo. The executive committee of the Japan-China Kidney Conference of JSN, Asian Integrated Nephrology Forum (AINF), led by Prof. Y Tomino was organized this conference. There were about 60 nephrologists and discussed topics on diabetic nephropathy. Invited speakers were Dr. Lin S, Dr. Chen S, Dr. Tian X, Dr. Tang W, and Liu ZH from China, and Dr. Shikata K, Dr. Kaizu K, Dr. Makita Y, Dr. Suzuki D, and Dr. Nakao T from Japan. The proceeding of this conference is now available in Nephrology Frontier 4; 143-169, 2005 (Medical Review Co., Ltd.). This conference is part of the activities of JSN. One of the goals of JSN is to promote international exchange, in particular with Asian countries. As was presented at the last Japan Kidney Week (by Dr. Wang H), the incidence of DM nephropathy in Beijing and Shanghai area was similar to Japan. Obesity-related renal disease is really an emerging issue in clinical nephrology. Racial disparities associated with CKD and ESRD are increasingly recognized worldwide. This should be most serious among Asian countries. This conference is planned up to 4th conference and a good chance to get in touch with Chinese culture and research activities. The second conference will be held on Sept. 9 (Fri.) in Beijing.
● First JSN Seminar for postgraduate trainees First JSN Seminar for postgraduate trainees was held on August 7, Sunday, in Tokyo. This seminar was designed to promote JSN activities on pre and postgraduate training by the subcommittee (led by Prof. H Imai). Member of the task force were volunteered to support the seminar. The number of attendee was about 100. After the welcome message from Dr. Gejyo (president of the JSN), first session was on structure and function of kidney by Dr. Imai and Dr. Yoshida, and the second session was clinical cases of renal failure by Dr. Nishi and Dr. Yamagata. The third session was given by Dr. Kurokawa with inspiring talk, and discussed one interesting case of acid-base disturbance. After one hour of lunch-break, attendees were separated into 11 groups with tutors of the task force. After a short ice-breaking time, they discussed freely with the assigned topics. The fourth session was case studies with potassium and sodium abnormalities by Dr. Nangaku and Dr. Sudo. The final session was cases studies with proteinuria and hematuria by Dr Yasuda and Dr Imai. Attendees might have interest in nephrology and are expected to choose nephrology service in any areas of Japan. This seminar should be the first step to bring the legend of Japanese nephrology both clinical and basic research to young generation. The second seminar will be held in Okinawa on Nov. 19 & 20.
● Continuous Medical Education (CME) 2005 CME-2005 was held in great success during the Japan Kidney Week. More than 400 attended and discussed with three interesting biopsy cases. This session was planned and organized with the subcommittee for pre and post education in the JSN committee (led by Prof H Imai). Demands for the proper handling and accurate evaluation are increasing. However, we admit that the training for clinical pathology is lacking in most of institutions. JSN is to take initiative to change such situation. Topic of the CME-2005 was infection and renal disease; post-infectious acute glomerulonephritis, shunt nephritis, glomerulonephritis associated with sub-acute endocarditis, MRSA nephritis, and hepatitis associated nephritis. Three case presentation by Dr. Ohtani(Akita), Dr. Koya(Kanazawa), and Dr. Sasatomi (Fukuoka). Dr. Kitamura(Chiba),Dr. Joh (Chiba), Dr. Ehara(Nagano), and Dr. Uesugi (Fukuoka) evaluated the biopsy findings, and each case was wrapped-up by Prof. H Imai. PDF files containing pathology slides are available through JSN homepage (JSN member only). CME-2006 will follow next year at the 49th annual meeting of JSN (President, Prof E. Higashihara).
● Special Program at Japan Kidney Week (JKW):
JKW was finished with great success: the attendees were 4500 for JSN and 15000 for JSDT. On the first day of JKW, a special program titled "Fight against chronic kidney disease (CKD)" was held with several hundreds of physicians' attendance on June 23, Thursday. Prof. Makino and Prof Hishida chaired the session. Prof Gejyo, president of the JSN, stated at the opening remarks "This symposium is to kick-off the activities of the JSN against CKD and ESRD". Dr. Y Tsukamoto introduced the activities of the Kidney Disease Improving Global Outcomes (KDIGO), while he is an active member of the committee. He also reported the results of the questionnaire sent to the JSN members concerning the definition of CKD and the points of KDIGO guidelines. He recommended the use of microalbuminuria as a marker of CKD. Dr. G Eknoyan extended the KDIGO activities. He stressed that the simple number of GFR; 90, 60, 30, and 15 ml/min/1.73m2 is easy to remember for physicians and patients. Currently, he is traveling all-around the world to spread the guidelines of KDIGO. Dr H Wang reported the current situation of CKD screening and ESRD treatment in China. She admitted the wide gap exist between rural area and urban area in China. In Beijing, the incidence of ESRD was doubled from 2002 (146 pmp) to 2003 (280 pmp). Although the prevalence was still lower (627 pmp) than Japan, the incidence was similar to Japan and will exceed soon. Dr. K Iseki reported the epidemiological studies conducted in Okinawa for the past 17 years. He showed the predictive power of the commonly measured variables at the screening. Among them, dipstick positive proteinuria and hypertension was the most powerful predictor of developing ESRD. Whether the annual screening for asymptomatic individuals is worthwhile or feasible is open question.
JSN will move to Hongo from Kyobashi on Aug. 5 & 6. JSN executive board has decided to move it's headquarter mainly because of financial reasons. New address is 3-28-8 Hongo, Bunkyo-Ku, 113-0033, Tokyo. Spaces for JSN will be narrower than before, but we could be shared the spaces, if needed, with other societies including the Japanese Society of Internal Medicine. JSN is going to cooperate with many societies and associations such as Japan Diabetes association. TEL：03-5842-4131 (ext 4132), FAX：03-5802-5570
Summer School at Shinshu: Renal biopsy class will open on August 13 (Saturday) and 14 (Sunday) at Shinshu University, Matsumoto, Japan. JSN has been working for the improvement of the quality of renal biopsy-related medicine in Japan. As a first step, the guideline concerning how to make the histological diagnosis was published for the standardization of histological diagnosis on June, 2005. Working group was organized in the Science Committee (under the leadership of Prof, Shigematsu). This summer school is the first to spread the ideas of this guideline with the full support from the Department of Histopathology, Shinshu University. Japanese Renal Pathology Association sent members and joined the activities. Curriculum of the course include: orientation to the guideline, workshop on the renal biopsy diagnoses using light, immunofluorescent, and electron microscopy, free talks on renal biopsy, and invited lecture by Dr. H Shigematsu, honoree professor at Shinshu University. Members of the Japanese Renal Pathology Association also participate for the class. Expected attendees are those who are interested in renal biopsy and renal pathology. Two-day course might be too short for those who would like to learn everything. However, if this event is successful, a series of such class might follow. For those who need more information: mail to moonkid@sch.md.shinshu-u.ac.jp
The Diabetic Nephropathy Remission and Regression by Intensive Care Team Trial-Japan (DNETT-Japan) is organized by Prof. H Makino (Okayama University) to evaluate the effects of intensive care on diabetic nephropathy. This study is supported by the grant from the Health Sciences Research Grants conducted by Ministry of Health Labor and Welfare, Japan. Eligible subjects are those with type 2 DM patients with overt nephropathy (urinary albumin excretion more than 300 mg/day and serum creatinine less than 2.5 mg/dl. For more information, ask Dr. K Shikata at shikata@md.okayama-u.ac.jp, or send Fax to 81-86-222-5214. Diabetic nephropathy is the leading cause of end-stage renal disease since 1998 in Japan, and now it is more than 40% of the incident dialysis patients. According to the recent government report, the number of DM patients is at least 7.4 millions Obviously, multi-disciplinary is required to treat such patients populations. Currently, several associations such as Japan Medical Association, Japanese Society of Diabetes, and other societies including patients and families put the highest priority for caring DM patients. Obviously, JSN is supporting these activities. However, scientific evidences regarding therapeutic regimens are lacking for Japanese. DNETT will offer some of the benefits of intensive team care.
Task Force for Decreasing CKD and ESRD (Chaired by Prof. S Matsuo) has organized a working group on the epidemiological studies on the prevalence of CKD. To construct preventive strategy for ever-increasing ESRD, it is important to estimate the size of the population at risk of developing ESRD. The working group has collected local registry data with more than 500,000 screenees after obtained permission from each institutes or organization. All database were treated with great caution on the privacy act and was used only numerical data. Personal data to identify screenees were deleted completely Results were adjusted to the standard population of Japan and the estimated number of CKD in Japan was estimated. Symposium will be scheduled on the coming Japan Kidney Week (June 23, Thursday). Two outstanding researchers on CKD from abroad will also join the symposium. And the estimated number of CKD in Japan was estimated. Symposium will be scheduled on the coming Japan Kidney Week (June 23, Thursday). Two outstanding researchers on CKD from abroad will also join the symposium. There will be a hot discussion concerning the prevalence and diagnostic criteria of CKD. The definition of CKD by the K/DOQI guideline criteria, which is commonly used worldwide, has not been applied to Japanese. It is still debatable on the racial factor for Japanese to adjust for the MDRD formula. One may argue for the different effect of diet, culture, and body size itself. The cut off level of GFR, 60 ml/min/1.73m2, might be higher for Japanese. This is the first-step forward on the preventive initiatives of JSN. Results will be a significant impact on the daily practice of medicine not only nephrologist but also other specialties with concerning elderly population. | page top | ● Pondering CKD prevalence in Japan Task Force for Decreasing CKD and ESRD (Chaired by Prof. S Matsuo) has organized a working group on the epidemiological studies on the prevalence of CKD. To construct preventive strategy for ever-increasing ESRD, it is important to estimate the size of the population at risk of developing ESRD. The working group has collected local registry data with more than 500,000 screenees after obtained permission from each institutes or organization. All database were treated with great caution on the privacy act and was used only numerical data. Personal data to identify screenees were deleted completely Results were adjusted to the standard population of Japan and the estimated number of CKD in Japan was estimated. Symposium will be scheduled on the coming Japan Kidney Week (June 23, Thursday). Two outstanding researchers on CKD from abroad will also join the symposium. And the estimated number of CKD in Japan was estimated. Symposium will be scheduled on the coming Japan Kidney Week (June 23, Thursday). Two outstanding researchers on CKD from abroad will also join the symposium. There will be a hot discussion concerning the prevalence and diagnostic criteria of CKD. The definition of CKD by the K/DOQI guideline criteria, which is commonly used worldwide, has not been applied to Japanese. It is still debatable on the racial factor for Japanese to adjust for the MDRD formula. One may argue for the different effect of diet, culture, and body size itself. The cut off level of GFR, 60 ml/min/1.73m2, might be higher for Japanese. This is the first-step forward on the preventive initiatives of JSN. Results will be a significant impact on the daily practice of medicine not only nephrologist but also other specialties with concerning elderly population.
● What's New in Publication Committee? The Publication Committee, led by Prof. F Shimizu, is playing a major role of publishing scientific activities of JSN. Two journals such as Japanese Journal of Nephrology (JJN) and Clinical and Experimental Nephrology (CEN) have been published under the control of this committee. In 2004, the number of papers published was 27 in JJN (vol. 46) and 64 in CEN (vol. 8). JJN had been the official "Japanese" Journal of Nephrology until CEN joined in 1997. Recently, JJN has series of articles of the prominent Japanese Nephrologist and Primers of Nephrology to learn the legend of JSN. It has been well accepted for Japanese readers. However, cope with the needs for international exchange of ideas and scientific outcomes, official JSN journal written in English was expected. Until recently, CEN has been suffering for small number of papers submitted and was scarcely cite in the international database. However, after this committee succeeded in letting CEN be indexed and included in Index Medicus and MEDLINE, the number started to increase, resulting in the fact that the number of papers submitted for CEN was 111 in 2004. Publication committee is making efforts to get Impact Factor (IF) for CEN. To improve the content and quality, CEN is also inviting reviewers worldwide. One of the goals of JSN is to play a leading role in developing countries in Asia. They are expecting more excellent papers submitted from allover the world, in particular from Asian countries.
The 2005 Spring JSN Executive Board Meeting, chaired by Prof F Gejyo, was held on April 25, 2005, in Tokyo. All board members (N=20) attended and discussed every aspect of JSN activities. Before this meeting, seven chairmen of the committees of the JSN (publication, finance, promotion of the JSN, clinical nephrology board examination, planning and administration, public relations, and ethics) have presented their activities, concerns, and future plans. The committee secretaries (chief secretary; Prof T Watanabe, and 11 other members of the secretary) have prepared the Agenda for the Executive Board Meeting. The main topics were 1) restructuring the future JSN scientific meeting, 2) the 50th anniversary of JSN in 2007, and 3) task force for decreasing CKD and ESRD. Comply with the increasing number of JSN members, need for long-term policy, and cost-saving JSN has decided to organize by itself and to take the initiatives. To begin with, JSN is negotiating with the Japanese Society of Dialysis Therapy to share the scientific meeting (so called Japan Kidney Week) as has been accomplished on 1999 and 2005. JSN is planning special programs for the coming 50th anniversary in 2007. It should be a milestone to publicize the activities of JSN. Fighting against CKD and ESRD: purpose of the Task Force would be prefect for the idea. JSN is going to expand the activities of the Task Force. The 2005 Autumn Meeting will be held on October 31 in Tokyo.
JSN is ambitious to recruit young doctors who are not yet determined their sub-specialty. Japan has changed the post-graduate training system in 2004. Physicians who passed the national examination are asked to complete two years of clinical training. The initiatives of matching have moved from the medical school to the national matching center. Most divisions of nephrology both universities and hospitals might have difficulties to recruit future nephrologist. They should be trained in facilities where Board Certified Nephrologist is working. The current number of JSN member was 7802 and that of Board Certified Nephrologist was 2647 in September 2004. The Board Certified Nephrologist has at least 5 years of JSN membership and certain skills and knowledge. Among the Board Certified Nephrologist, Attending Nephrologist was certified. He (she) has at least 10 years of JSN membership and experience in nephrology. JSN acts to promote the post-graduate training system. The sub-committee of pre- and postgraduate training in Nephrology (led by Professor H Imai), under the Committee of the Clinical Nephrology Board Examination (chaired by Professor A Koyama) is planning several activities on this important issue. The first Seminar organized by the sub-committee will be held on August 7, Sunday, in Kasumigaseki building, Tokyo. The expected attendee will be 100 who will finish two years training next spring. In 2005, there will be another seminar, which is held in Okinawa. Details of this seminar will be found in the home page in www.jsn.or.jp.
The progress report on proper handling of renal biopsy specimen has published recently from JSN (Jpn J Nephrol 46: 747-780, 2004). The task force, led by Professor H Makino, was organized on November 2002 in the Committee of Planning and Administration in JSN (Chaired by Professor A Hishida). The intention was to promote the proper use of the information of renal biopsy and hope to reduce the incidence of ESRD in Japan. To begin with, they sent the questionnaire to the JSN member concerning the handling of renal biopsy specimen. Among the 92 universities or hospitals, eighty-six have answered the questionnaire: RBX specimens were processed by those who have obtained the specimen (77%) and electron microscopy was available in 69% of the facilities. However, many felt that there were not necessarily satisfied or confident with the diagnosis. Some specimens are too difficult to make histological diagnosis. Certainly, there are shortening of renal pathologist or might be a lack of communication between nephrologist and pathologist. There are also discrepancies in the terminology used in the pathology report. In the progress report, they proposed using similar format when requesting to the pathologist from nephrologist and reporting to nephrologist from the pathologist. In this August, there will be a seminar on this report hoping to prevail the standard formula and to educate young nephrologist. Such action might facilitate the communication between nephrologist, renal pathologist, and others, and therefore the information of renal biopsy might be more valuable.
Reviews titled Kidney Transplantation Series have been published in the Japanese Journal of Nephrology, Japanese version of the official journal of JSN, since January 2004. The prevalence of dialysis population is largest in the world, more than 1800 per million populations, in Japan. However, the rate of kidney transplantation has been low as less than 10 per million populations. This number is lowest among several Asian countries. We have no good explanation for this, but we admit that our community is not so enthusiastic for kidney transplantation. It is often neglected as an option for renal replacement therapy for ESRD patients. To promote kidney transplantation, a special task force was organized in the Committee of Planning and Administration in JSN (Chaired by Professor A Hishida). Dr Yasushi Asano, former president of JSN, wrote in the preface of the series: promoting kidney transplantation is one of the important goals of JSN. With advancement of anti-immune therapy, kidney transplantation with ABO-incompatible and living-unrelated (spouse) donation have been performed in Japan. In 2002, the total number of kidney transplantation was 807 (634 living related and 173 cadavers). The largest number so far accomplished was 808 in 1989. Despite the introduction of the law concerning the definition of brain death in 1999, the number of cadaver kidney transplantation has not increased.
JSN has released the Renal Biopsy Guidebook for general practitioners and nephrologists in Japan . The Committee of Planning and Administration (Chaired by Prof. A Hishida) begun to wrap-up the current practice on renal biopsy in Japan from 2002 (Working group for the renal biopsy guidebook led by Dr H Hirakata) and published the Renal Biopsy Guidebook in 2004. The purpose of this book was to recommend the safe procedure of renal biopsy. Firstly, they did a nationwide survey on the practice of renal biopsy. There are several opinions and comments on the indication, contra-indication, and the procedures are different in detail. Some issues might need to prove by prospective study. The guidebook noted mostly the consensus by our colleagues. There are also ethical problems on performing renal biopsy in patients with high-risk such as bleeding tendency and single kidney. Benefits of renal biopsy remained to be proved apart from the scientific one. Information obtained by renal biopsy is vital to progress our understanding of renal disease. There will be some points to discuss more openly concerning the daily clinical practice (clinical merit for the patient) and research purpose (merit for the general people). The guidebook is important to make clear the current situation in our society. The content of the guidebook might change in near future. Excerpts of this guidebook are available in JSN homepage (www.jsn.or.jp).
Japan entered new era under the "Privacy Act" to protect human right against the violation of privacy. Japanese have been living in the society without "privacy act". With the rapid advancement of information technology (IT), there are many incidents of stealing or un-authorized use of information concerning customer's privacy from banks, companies, associations, and other agencies. We often receive direct mails from commercial companies; suggesting that directories may have transferred to others. After April 1, 2005, the "Privacy Act" such actions will be prohibited. In the filed of medicine, we are expected to be cautious about the privacy such as name, address, diagnosis, and other medical information much more than before. Every clinical and epidemiological study should be performed with due process under this law. There should be no clues to identify person(s) when published or open to public. This law might or might not facilitate publication in English from Japan. We experienced acute decrease in cadaver kidney donation after the introduction of "Law about organ transplantation after brain death". Proper use of information regarding personnel identifier is mandatory in clinics, hospital, and agencies. A list of "certified nephrologist and their work place" is available after recognition of this Law in JSN.
We registered 52 cases of "Sugihiratake-associated acute encephalopathy" in Tohoku and Hokuriku area, northern part of Japan, by October 22, 2004. Fifteen out of them (29%) have died and several others are on artificial respirator. as confirmed at the end of October 2004. Sugihiratake (Pleurocybella porrigens) is a favorite ingredient in Miso-soup in Tohoku and Hokuriku area and has been considered a non-toxic mushroom (Take). Therefore, it has been consumed many years before the outbreak even in patients with CKD and ESRD. The main symptoms were fatigue, difficult to walk, convulsion, and coma, but were no fever and no digestive or hepatic abnormality. The CSF showed no increase in cells, but found only slight increase in protein. Most of them had taken Sugihiratake several days to 2 weeks before the onset of the symptoms. The mean duration was about 8 days and the mean age was 68.5 years. Upon further inquiry, we found at least two more cases, which occurred before this outbreak. Both of them were on chronic dialysis. The nature of this outbreak is not yet certain, but most of the patients are on chronic hemodialysis. According to the survey of 9 dialysis units in the affected area, 278 out of 524 patients had consumed Sugihiratake in 2004. Twelve of them (4%) had encepharopathy. There was no intimate relationship between the amount of Sugihiratake intake and the incident. Causative agent(s) remained speculative. It is advised that Sugihiratake should be avoided in dialysis patients and also with significant renal dysfunction. For inquiry and further information, mail to Dr I. Narita (naritai@med.niigata-u.ac.jp) or (office@jsn.or,jp).
I have been serving as a president of the JSN since 2004. It is my great honor and privilege to work together with many Japanese colleagues. JSN has more than 7,725 members and is still growing. We have accomplished a great deal of development for the past 45 years. Our goal is to strengthen our tradition further and to facilitate research, treatment, and education on renal diseases. Our aim is high and we should share our knowledge and experience with other organizations and societies not only in Japan but also internationally. In 2005, the 48th JSN annual meeting will be held with the 50th Japanese Society for Dialysis Therapy (JSDT) in Yokohama as a Japan Kidney Week. We welcome your comments and support to JSN. Dr. Fumitake Gejyo is a professor of medicine in Niigata University. He is not only a leader of Division of Nephrology (Second Department of Internal Medicine) but also a director of the Hospital of the Niigata University. He is well known as a first researcher of reporting the nature of dialysis related-amyloidosis. He found that the accumulation of beta-2-microglobulin was the culprit of amyloidosis in long-term dialysis patients.
● Dr H. Imai for the ISN Council Member!! (Updated April 4, 2005) |
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Dr Hirokazu Imai, the Professor at Aichi Medical University School of Medicine, is an active member of the Japanese Society of Nephrology (JSN) and would be a next Council member of the ISN. He believes that the globalization in Nephrology does not mean the enforcement of global standards, but the coordination between global standards and local decisions. |
He has been a most prolific investigator. He has introduced ddY mice as a spontaneous model of Ig A nephropathy and proposed that human membranous nephropathy is IgG4 deposition disease. He has contributed as a member of Committee Secretaries of the JSN to release information to the fellows of the JSN by e-mail and to receive constructive comments from the JSN members. He is also a director of the under- and postgraduate education committee consisting of almost 50 active members, working on self-assessment programs and seminar for students and residents. His ISN goals include the building of a new network and to make a new educational system under the concept of the global advancement of nephrology. JSN is entirely support his vision and recommends him as a next Council member of ISN. He deserves the position as Dr S. Sasaki does.
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The 3 rd Korea-Japan Nephrology Forum was held at the Shilla Hotel in Seoul, Korea on March 19, 2005. This Forum was organized under the auspices of Korean Society of Nephrology and Japanese Society of Nephrology. The Asian Integrated Nephrology Forum (AINF), a subcommittee in the JSN, which is chaired by Professor Y. Tomino has participated for the planning of this Forum. The main theme was Diabetic Nephrology. A total of 10 speakers, 4 from Japan and 6 from Korea, have presented their interesting research topics related to the main theme. The proceedings of this Forum will be published in the Nephrology soon. There were about 110 attendees from entire area of Korea. This was quite significant as the total number of nephrologist was about 600 in Korea. This Forum is becoming a cornerstone for strengthening the friendship and scientific interaction between two countries. The 4 th Korea-Japan Nephrology Forum will be held in Tokyo on March 11 (Saturday), 2006. The main theme will be Dialysis.
●Task Force for Decreasing CKD and ESRD (Updated March 15, 2005) JSN has started a comprehensive action on ever-increasing ESRD
population (Task Force for Decreasing CKD and ESRD). The goal is to decrease
CKD population and to prevent ESRD.
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