Greetings
Our division provides care for a wide range of conditions, including kidney diseases, endocrine disorders, and diabetes. In nephrology, we manage primary glomerular diseases, such as chronic glomerulonephritis and nephrotic syndrome, as well as secondary kidney disorders caused by cancer or autoimmune diseases. We also treat acute kidney injury, electrolyte imbalances, and chronic kidney disease. For patients with kidney failure, we offer hemodialysis, peritoneal dialysis, and kidney transplantation in close collaboration with the Department of Transplant Surgery. We work with other specialties to manage dialysis-related complications and provide comprehensive care. Within our division, the metabolic disease and endocrine subgroups work together to treat lifestyle-related and hormonal disorders. We provide continuous diabetes care, from early-stage kidney disease to kidney failure, ensuring treatment tailored to each patient.
Head of the Division of Nephrology, Endocrinology and Metabolism
Hirotaka Komaba
Treatment details
The Division of Nephrology, Endocrinology, and Metabolism provides care for a wide range of conditions, including kidney diseases, endocrine disorders, and diabetes.
In nephrology, we cover the full spectrum of kidney diseases, from the diagnosis and treatment of conditions such as chronic glomerulonephritis and nephrotic syndrome, to conservative management of chronic kidney disease (CKD), initiation of kidney replacement therapies for kidney failure, and management of complications in dialysis patients. Regarding kidney replacement therapies, we offer hemodialysis, peritoneal dialysis, and actively participate in kidney transplantation in collaboration with the Department of Transplant Surgery, allowing us to provide all available treatment options. We also manage complications in dialysis patients, such as vascular access issues and secondary hyperparathyroidism, in cooperation with the Department of Transplant Surgery and other related departments, serving as a comprehensive medical center for maintenance dialysis patients in the region from western Kanagawa to eastern Shizuoka.
In endocrinology, we primarily provide outpatient care for pituitary, adrenal, and thyroid disorders, offering consistent management from diagnosis through treatment.
For diabetes, we provide integrated care ranging from early-stage disease to patients with complications, especially diabetic nephropathy. In addition to conventional insulin therapy, we actively employ advanced treatments such as insulin pumps and intermittent continuous glucose monitoring (iCGM).
Main target diseases
1. Kidney disease
We provide diagnosis and treatment for primary glomerular diseases, such as chronic glomerulonephritis and nephrotic syndrome. In addition, we manage secondary glomerular diseases, including diabetic nephropathy and those associated with malignancies or autoimmune disorders. For hereditary kidney diseases, such as polycystic kidney disease, Alport syndrome, and Fabry disease, we now perform genetic testing in collaboration with other academic and medical institutions to achieve accurate diagnoses.
We are also equipped to respond promptly to acute kidney injury, including rapidly progressive glomerulonephritis, and disorders of water and electrolyte balance. In particular, we offer specialized care for abnormalities in calcium and phosphate metabolism, as well as bone and mineral disorders associated with chronic kidney disease (CKD-MBD). We also accept referrals for patients with advanced CKD who may require future kidney replacement therapy.
For patients with kidney failure, all forms of kidney replacement therapy are available, including hemodialysis, peritoneal dialysis, and transplantation. We can also initiate home hemodialysis when appropriate.
2. Endocrine disorders
We provide outpatient care for a wide range of hormone-producing organs, including the pituitary, adrenal, thyroid, parathyroid, and gonads. Our hospital is equipped to perform all necessary endocrine tests and imaging studies. Endocrine stimulation and suppression tests, which are essential for diagnosis, are actively conducted. In particular, for suspected conditions such as primary aldosteronism or Cushing’s syndrome, patients may be admitted for multiple endocrine stimulation tests to establish a precise diagnosis. When treatment of an endocrine disorder requires surgery, we work closely with surgical departments, including the Department of Neurosurgery, the Department of Urology, and the Department of Otolaryngology–Head and Neck Surgery, to provide prompt and coordinated care.
3. Diabetes
The goal of diabetes treatment is to maintain good blood glucose control in order to prevent or slow the progression of microvascular complications, such as neuropathy, retinopathy, and nephropathy, as well as macrovascular complications, including myocardial infarction and stroke, enabling patients to live a normal daily life. Patient education is considered essential to achieve this goal. At our hospital, we offer a diabetes education program during hospitalization, where physicians, nurses, pharmacists, dietitians, clinical laboratory technicians, dental hygienists, and physical therapists work together to engage patients actively and enhance their understanding and motivation for treatment. When selecting treatment, we consider the underlying pathophysiology, including insulin resistance, impaired insulin secretion, and glucotoxicity, while tailoring therapy to each patient’s lifestyle. For intensive insulin therapy or injectable GLP-1 receptor agonists, we actively utilize intermittent continuous glucose monitoring (iCGM) devices. We also have extensive experience in managing type 1 diabetes, with widespread use of insulin pumps (CSII and SAP). In addition, we are well-equipped to handle acute complications, such as hyperglycemic emergencies and severe hypoglycemia, providing care not only for chronic management but also for acute-phase conditions.
Main medical achievements
(FY2024)
・Kidney biopsies: 143 cases (including 54 transplant kidney biopsies)
・Acute kidney injury requiring kidney replacement therapy: 124 cases
・Blood purification therapies: 49 cases
・Initiation of hemodialysis: 97 cases
・Initiation of peritoneal dialysis: 4 cases
・Kidney transplant consultations: 18 cases
・Endocrine stimulation/suppression tests: 132 cases
・Diabetes education hospitalizations: 9 cases
・Initiation of insulin therapy: 159 cases
・Diabetes co-management with other departments: 618 cases
・Insulin pumps: 43 cases
Doctor List
Division Head: Dr. Hirotaka Komaba
Chief Attending Physician of Ward 14A: Dr. Masahiro Koizumi
Division Website:https://www.fuzoku-hosp.tokai.ac.jp/service/jin-naika/
https://u-tokai-nem.jp/
Outpatient Clinic: +81-463-93-1121, Ext. 6181
Professor Hirotaka Komaba
| Specialization | Kidney diseases, kidney failure, dialysis |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology; Japanese Society for Dialysis Therapy |
| Specialized Areas | Chronic kidney disease |
| Outpatient medical day | Tuesdays, Thursdays |
Professor Masao Toyoda
| Specialization | Diabetes |
|---|---|
| Specialist | Japanese Society of Internal Medicine (Board-Certified Internist / Teaching Physician); Japanese Diabetes Society (Board-Certified Diabetologist / Teaching Physician) |
| Specialized Areas | Diabetes |
| Outpatient medical day | Monday, Tuesday, Thursday |
Associate Professor Moritsugu Kimura
| Specialization | Diabetic kidney disease |
|---|---|
| Specialist | Japanese Society of Internal Medicine (Board-Certified Internist / Teaching Physician); Japanese Diabetes Society (Board-Certified Diabetologist / Teaching Physician); Japanese Society of Nephrology (Board-Certified Nephrologist / Teaching Physician) |
| Specialized Areas | Diabetes |
| Outpatient medical day | Monday, Thursday, Friday |
Associate Professor Masahiro Koizumi
| Specialization | Kidney diseases, kidney failure |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology; Japanese Society for Dialysis Therapy; Japanese Society of Hypertension; Japanese Society of Clinical Kidney Transplantation |
| Specialized Areas | Chronic kidney disease |
| Outpatient medical day | Friday, Saturday (1st and 3rd weeks) |
Lecturer Atsushi Yasuda
| Specialization | Endocrine hypertension |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Endocrine Society (Endocrinology & Metabolism) |
| Specialized Areas | Thyroid, parathyroid, adrenal, pituitary, gonads |
| Outpatient medical day | Tuesday, Friday, Saturday |
Lecturer: Yosuke Nakagawa
| Specialization | Kidney diseases, kidney failure, dialysis |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology; Japanese Society for Dialysis Therapy |
| Specialized Areas | Chronic kidney disease, glomerulonephritis / nephrotic syndrome, bone and mineral disorders, electrolyte and fluid disorders |
| Outpatient medical day | Tuesday |
Assistant Professor Yuna Onozawa
| Specialization | Kidney diseases, kidney failure, dialysis |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology |
| Specialized Areas | Chronic kidney disease, glomerulonephritis / nephrotic syndrome, electrolyte and fluid disorders |
| Outpatient medical day | Monday |
Assistant Professor Konomi Isozumi
| Specialization | Diabetes |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Diabetes Society |
| Specialized Areas | Diabetes |
Assistant Professor Yosuke Matsuda
| Specialization | Diabetes |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Diabetes Society |
| Specialized Areas | Diabetes |
| Outpatient medical day | Wednesday |
Norisuke Shimamura (Graduate student)
| Specialization | Kidney diseases, kidney failure |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology |
| Specialized Areas | Chronic kidney disease, glomerulonephritis / nephrotic syndrome, electrolyte and fluid disorders |
| Outpatient medical day | Monday (PM), Wednesday |