Greetings
Our department provides medical care for a wide range of diseases, including kidney diseases, endocrine disorders, and diabetes. In the nephrology department, we diagnose and treat chronic glomerulonephritis and nephrotic syndrome, as well as secondary glomerular diseases caused by malignant tumors and collagen diseases. We also have extensive experience in managing acute kidney injury, fluid and electrolyte imbalances, and chronic kidney disease. For end-stage renal failure, in addition to initiating hemodialysis and peritoneal dialysis, we actively participate in living donor kidney transplantation in collaboration with Transplant Surgery. We also provide comprehensive care for various complications that occur during maintenance dialysis, working in cooperation with other departments. Furthermore, our metabolic department, which handles diabetes, hypertension, and dyslipidemia, and our endocrinology department, which deals with hormonal disorders, collaborate to provide care for a wide range of patients.
Head of the Division of Nephrology, Endocrinology and Metabolism
Hirotaka Komaba
Treatment details
Department of Renal Endocrinology and Metabolism provides medical care for a wide range of diseases, including kidney diseases, endocrine disorders, and diabetes.
Regarding kidney diseases, we provide comprehensive care ranging from the diagnosis and treatment of chronic glomerulonephritis and nephrotic syndrome to conservative treatment of chronic kidney disease (CKD), the introduction of renal replacement therapy for end-stage renal failure, and the management of complications in dialysis patients. For renal replacement therapy, in addition to introducing hemodialysis and peritoneal dialysis, we actively participate in living donor kidney transplantation in collaboration with Transplant Surgery, allowing patients to choose renal replacement therapy according to their condition and preferences. We also manage complications such as shunt problems and secondary hyperparathyroidism in dialysis patients in cooperation with Transplant Surgery and other related departments. Our department serves as a comprehensive medical center for maintenance dialysis patients in the western Kanagawa Prefecture and eastern Shizuoka Prefecture region.
Regarding endocrine disorders, we provide outpatient care focusing on pituitary, adrenal, and thyroid disorders, offering comprehensive treatment from diagnosis to management.
Regarding diabetes, we provide consistent treatment for patients ranging from those with early-stage diabetes to those with complications such as diabetic nephropathy. In addition to conventional insulin therapy, we are also actively engaged in advanced diabetes treatments such as insulin pumps and flash glucose monitoring (iCGM).
Main target diseases
1. Kidney disease
We diagnose and treat primary glomerular diseases such as chronic glomerulonephritis and nephrotic syndrome. Furthermore, we also diagnose and treat secondary glomerular diseases associated with diabetic nephropathy, malignant tumors, and collagen diseases. For hereditary kidney diseases such as polycystic kidney disease, Alport syndrome, and Fabry disease, we have recently been collaborating with other educational and medical institutions to conduct genetic testing and facilitate diagnosis.
We can provide prompt treatment for acute kidney injury (including rapidly progressive glomerulonephritis) and water and electrolyte imbalances. In particular, we provide specialized care for calcium and phosphorus metabolism disorders and bone and mineral metabolism disorders associated with chronic kidney disease (CKD-MBD). We also accept referrals of patients with advanced CKD in the conservative management stage, with a view to initiating renal replacement therapy.
For end-stage renal failure, we offer both dialysis (hemodialysis and peritoneal dialysis) and transplantation therapy, allowing patients to choose the renal replacement therapy that best suits their condition and preferences. We also provide support for the introduction of home hemodialysis.
2. Endocrine disorders
We provide outpatient care for diseases affecting various hormone-producing organs, including the pituitary gland, adrenal glands, thyroid gland, parathyroid gland, and gonads. Our hospital is equipped to perform various endocrine tests and imaging tests necessary for diagnosing these conditions. We also actively conduct endocrine loading tests, which are crucial for diagnosing endocrine diseases. In particular, when primary aldosteronism or Cushing's syndrome is suspected, we conduct multiple endocrine loading tests during hospitalization to ensure an accurate diagnosis. Furthermore, in cases where surgery on endocrine organs is necessary for the treatment of endocrine diseases, we work closely with surgical departments such as Neurosurgery, Nephrology and Urology, Otolaryngology, Head and Neck Surgery to provide prompt treatment.
3. Diabetes
The goal of diabetes treatment is to control blood glucose levels effectively, thereby preventing the progression of microvascular complications such as neuropathy, retinopathy, and nephropathy, as well as macrovascular complications such as myocardial infarction and cerebral infarction, enabling patients to live a normal daily life. To achieve this, we believe that patient education is paramount. Our hospital implements a diabetes education inpatient program, where not only physicians, but also nurses, pharmacists, registered dietitians, laboratory technicians, dental hygienists, and physical therapists collaborate, prioritizing dialogue with patients to enhance their understanding and awareness of their treatment. In treatment, we select the most appropriate medication while considering the patient's lifestyle, taking into account conditions such as insulin resistance, insulin deficiency, and glucotoxicity. When administering intensive insulin therapy or injectable GLP-1 receptor agonists, we actively utilize flash glucose monitoring (iCGM) to support self-management. We also have extensive experience in treating type 1 diabetes and have introduced numerous insulin pumps (CSII, SAP). We have ample experience in inpatient treatment for hyperglycemic emergencies and severe hypoglycemia, and we can address not only chronic but also acute conditions.
Main medical achievements
(FY2024)
• Diagnosis by kidney biopsy: 143 cases (including 54 cases of transplant kidney biopsy)
124 cases of acute kidney injury requiring renal replacement therapy.
49 cases of specialized blood purification therapy
97 cases of hemodialysis initiation.
4 cases of peritoneal dialysis initiated.
18 cases of concurrent kidney transplantation.
• Endocrine disease challenge test: 132 cases
・Diabetes education hospitalization 9 cases
159 cases of insulin initiation.
・Collaborative diabetes care with other departments: 618 cases
43 cases of insulin pump management
Doctor List
Department Head: Komaba Daimine
Chief Physician of Ward 14A: Yosuke Nakagawa
Outpatient: 0463 (93) 1121 extension 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, bone and mineral metabolism disorders, parathyroid disorders |
| Outpatient medical day | Tuesdays, Thursdays |
Professor Masao Toyoda
| Specialization | Diabetes, kidney disease |
|---|---|
| Specialist | Japanese Society of Internal Medicine (Board-Certified Internist / Teaching Physician); Japanese Diabetes Society (Board-Certified Diabetologist / Teaching Physician) |
| Specialized Areas | Diabetes, diabetic nephropathy |
| Outpatient medical day | Monday, Tuesday, Thursday |
Associate Professor Moritsugu Kimura
| Specialization | Diabetes, 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 disease, renal failure, dialysis |
|---|---|
| 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, nephritis/nephrotic syndrome, hypertension, kidney transplant |
| Outpatient medical day | Friday, Saturday (1st and 3rd weeks) |
Lecturer Atsushi Yasuda
| Specialization | Endocrine disorders, hypertension, diabetes |
|---|---|
| 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 disease, renal failure, dialysis |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology; Japanese Society for Dialysis Therapy |
| Specialized Areas | Chronic kidney disease, nephritis/nephrotic syndrome, bone and mineral metabolism disorders, water and electrolyte imbalances, home hemodialysis |
| Outpatient medical day | Tuesday (with home hemodialysis outpatient clinic) |
Assistant Professor Yuna Onozawa
| Specialization | Kidney disease, renal failure, dialysis |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology |
| Specialized Areas | Chronic kidney disease, nephritis/nephrotic syndrome, water and electrolyte imbalances |
| 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 |
Assistant Professor Keisuke Ito
| Specialization | Diabetes |
|---|---|
| Specialist | Specialist in Internal Medicine, Japanese Society of Internal Medicine |
| Specialized Areas | Diabetes |
| Outpatient medical day | Monday |
Assistant Professor Kazumi Kozuka
| Specialization | Kidney disease, renal failure, dialysis |
|---|---|
| Specialist | Specialist in Internal Medicine, Japanese Society of Internal Medicine |
| Specialized Areas | Chronic kidney disease, nephritis/nephrotic syndrome, water and electrolyte imbalances |
| Outpatient medical day | Monday |
Norisuke Shimamura (Graduate student)
| Specialization | Kidney disease, renal failure, dialysis |
|---|---|
| Specialist | Japanese Society of Internal Medicine; Japanese Society of Nephrology |
| Specialized Areas | Chronic kidney disease, nephritis/nephrotic syndrome, water and electrolyte imbalances |
| Outpatient medical day | Monday (Peritoneal Dialysis Outpatient Clinic) and Wednesday |