[Evaluation of a Risk Communication Program for Pesticide Residues].

To promote and raise the awareness of accurate knowledge on pesticide residues, the symposium program on risk communication on pesticide residues was held by the broadcasted online style. The risk communication program was statistically evaluated using a pre- and post-program online questionnaire survey. We had the questionnaire answers of the 105 valid participants. The analysis of post-program questionnaires shows that the risk communication program was effective in terms of levels of understanding and interest. Pre-program risk perception or awareness of safety assessments was significantly and positively correlated with awareness for establishing standard values of pesticide residues by the analysis of pre-program questionnaires. Risk perception after the program was significantly higher than before the program, suggesting that risk perception increased due to the program by analysis the same question between pre- and post-program questionnaires. Multiple regression analysis suggests that the participants with higher pre-program awareness of safety assessments or pre-program awareness for establishing standard values appeared to have higher levels of understanding and post-program risk perception.

Review of the efficacy of AST-120 (KREMEZIN®) on renal function in chronic kidney disease patients.

AST-120 (KREMEZIN®) consists of oral, spherical carbon particles that adsorb uremic toxins and their precursors within the gastrointestinal tract, allowing them to be excreted in the feces. Uremic toxins such as indoxyl sulfate and p-cresyl sulfate are abundant in the blood of chronic kidney disease (CKD) patients and are related to the progression of both CKD and cardiovascular disease. AST-120 was approved in Japan in 1991 followed by Korea (2004), Taiwan (2007) and the Philippines (2010) for treating uremic symptoms and prolonging the time to initiation of dialysis in patients with progressive CKD. In this review, we provide an overview of the past clinical data on AST-120 from 1982 to 2013. The effect of AST-120 for renal events was not supported in the primary analysis of randomized clinical trials. However, post-hoc analyses revealed significant differences between the AST-120 and control groups in the second Japanese phase III trial and in the multinational Evaluating Prevention of Progression in CKD (EPPIC) trials. Furthermore, inhibitory effects on the progression of CKD, as represented by amelioration in the estimated glomerular filtration rate (eGFR) decline and serum creatinine (sCr) elevation were suggested. These results suggest that AST-120 delays the decline in renal function. In addition, AST-120 may prolong the time to the initiation of dialysis, especially in patients with progressive CKD. For further verification of the clinical efficacy of AST-120, future study inclusion criteria should be determined carefully, defining progressive CKD using markers such as declines in eGFR and sCr elevation.

Dynamic MR imaging of kidneys perfused with EOB-Gd-DTPA.

Gandolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a hepatobiliary contrast agent for MRI. It was reported that Gd-EOB-DTPA is useful to detect liver tumors and differentially diagnose benign and malignant pathologies in the liver. Since Gd-EOB-DTPA partially accumulates in the hepatocytes and bile via various transporters after intravenous injection, signal intensity in the liver increases on T1-weighted images. The signal intensity of the liver after Gd-EOB-DTPA injection depends on the Gd-EOB-DTPA uptake by hepatocytes and bile excretion. It is known tha the Gd-EOB-DTPA accumulating in the kidney is excreted to the urine through glomerular filtration. Because Gd-DTPA is concentrated in the renal tubules after being filtered at the Bowman's capsule, and since it is neither secreted nor reabsorbed the concentrating and diluting function of the renal tubules can be studied by imaging techniques. since renal function can be evaluated with Gd-EOB-DTPA can also be used to evaluate renal function. Eith the development of MRI equipment and rapid imaging techniques, temporal resolution had improved greatly. However, no previous study has been carried out on renal function using Gd-EOB-DTPA dynamic MR study that was correlated with estimated glomerular filtration rate (eGFR) and stage of chronic kidney disease (CKD) in the Japan Association of chronic kidney disease initiative.