Nephrorlogy and Rheumatology
Kidney is the indispensable organ that plays an important role in multiple functions maintaining metabolism, electrolyte balance, body fluid adjustment, etc. Kidney diseases include not only primary diseases, e.g. IgA nephropathy, minimal change disease, but also secondary to other systemic diseases, e.g. infection, collagen diseases, metabolic diseases, and drug-induced. Worldwide, patients with end-stage renal diseases (ESRD) and subsequent renal replacement therapy (RRT) is increasing steadily. To date, the number of patients with RRT in Japan surpassed 300,000 and this causes an increase of national medical expenses, so prevention of renal dysfunction progress should be accomplished immediately. In the purpose as mentioned above, KDIGO had proposed the disease concepts chronic kidney disease (CKD) and acute kidney injury (AKI) for early diagnosis and clarifying their epidemiology. In our department, many specialists in the areas of nephrology, rheumatology and metabolism perform management of various diseases, and research kidney diseases by both experimental and clinical approach.
Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complication and to reduce the risk of long-term complications. Management and education of diabetes for each patient is performed both by diabetologist and by co-medical stuff including nutritionist, nurse, physical therapist, pharmacist, and medical technologist. In our department, clinical problems of patients with diabetes are solved by many Board Certified Diabetologists, Certified Diabetes Educator of Japan, and other co-medical stuffs belonging to Diabetes Care Support Team.
Endocrinology is an essential field of clinical internal medicine, because hormonal system is required to maintain homeostasis in human physiology. Endocrinology has the old history, and 98th American Endocrine Society meeting and 89th Japan Endocrine Society meeting will be held in 2016. Our department is working as a center of clinical endocrinology in Kochi prefecture, and endocrine patients (e.g. pituitary, thyroid, adrenal diseases) and also obesity patients are properly diagnosed and treated. Because several cases are difficult to treat, we have clinical conference weekly. In the cases of patients need for surgery, we have careful discussion with endocrine surgeon or neurosurgeon. It’s important to study the way of diagnosis and treatment in each case for educating resident, and it’s encouraged to make case reports for understanding endocrine disease.