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KIBA Keisuke

    Kindai University Nara Hospital　Lecturer in Medical School
Last Updated :2024/04/25

Researcher Information

Degree

  • M.D.,Ph.D.（2019/03 Nara Medical University）

J-Global ID

Research Interests

  • 前立腺肥大症   Leg edema   Body position changing   hourrs of undisturbed sleep   Bioelectric impedance analysis   Nocturia   

Research Areas

  • Life sciences / Urology

Published Papers

  • Yasunori Akashi; Yutaka Yamamoto; Mamoru Hashimoto; Shogo Adomi; Kazutoshi Fujita; Keisuke Kiba; Takafumi Minami; Kazuhiro Yoshimura; Akihide Hirayama; Hirotsugu Uemura
    Cancers 15 (24) 2023/12 
    INTRODUCTION: Immune checkpoint inhibitor (ICI) therapy has significantly improved the prognosis of some patients with advanced urothelial carcinoma (UC), but it does not provide high therapeutic efficacy in all patients. Therefore, identifying predictive biomarkers is crucial in determining which patients are candidates for ICI treatment. This study aimed to identify the predictors of ICI treatment response in patients with platinum-refractory advanced UC treated with pembrolizumab. METHODS: Patients with platinum-refractory advanced UC who had received pembrolizumab at two hospitals in Japan were included. Univariate and multivariate analyses were performed to identify biomarkers for progression-free survival (PFS) and overall survival (OS). RESULTS: Forty-one patients were evaluable for this analysis. Their median age was 75 years, and the vast majority of the patients were male (85.4%). The objective response rate was 29.3%, with a median overall survival (OS) of 17.8 months. On multivariate analysis, an Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥ 2 (HR = 6.33, p = 0.03) and a baseline neutrophil-to-lymphocyte ratio (NLR) > 3 (HR = 2.79, p = 0.04) were significantly associated with poor OS. Antibiotic exposure did not have a significant impact on either PFS or OS. CONCLUSIONS: ECOG-PS ≥ 2 and baseline NLR > 3 were independent risk factors for OS in patients with platinum-refractory advanced UC treated with pembrolizumab. Antibiotic exposure was not a predictor of ICI treatment response.
  • Takeshi Inoue; Yoshitomo Chihara; Keisuke Kiba; Shuya Hirao; Masahiro Tanaka; Tatsuo Yoneda; Toshihisa Saka; Ken-Ichi Beppu; Keiichi Furubayashi; Mizuki Takashima; Hidenori Nagai; Hiroshi Kobayashi; Kiyohide Fujimoto
    Journal of microbiological methods 180 106103 - 106103 2021/01 
    We developed a rapid multiplex PCR assay available in bedside for the simultaneous detection of Neisseria gonorrhoeae and Chlamydia trachomatis, which enables diagnosis in less than 30 minutes. In this study, we validated the clinical utility of this assay including its sensitivity and specificity for NG and CT detection.
  • Motokiyo Yoshikawa; Kazumasa Torimoto; Akihide Hirayama; Keisuke Kiba; Yutaka Yamamoto; Yasunori Akashi; Nobutaka Shimizu; Nobumichi Tanaka; Hirotsugu Uemura; Kiyohide Fujimoto
    Neurourology and urodynamics 39 (5) 1550 - 1556 2020/06 
    AIMS: There is accumulating evidence that excessive salt intake contributes to nocturnal polyuria. We aimed to investigate the relationship between salt intake, leg edema, and nocturnal urine volume (NUV) to assess the etiology of nocturnal polyuria. METHODS: A total of 56 men aged ≥60 years who were hospitalized for benign prostatic hyperplasia or with suspected prostatic cancer were enrolled. Urine frequency-volume charts of the patients were maintained, and they underwent bioelectrical impedance analysis twice daily (at 5:00 pm and 6:00 am) and examination of blood (brain natriuretic peptide levels) and urine (sodium and creatinine levels and osmotic pressure) samples once daily (at 6:00 am). Free-water clearance, solute clearance, and sodium clearance at night were measured, and daily salt intake was estimated. RESULTS: The data of 52 patients were analyzed. Daily salt intake positively correlated with leg edema at 5:00 pm, differences in leg extracellular fluid levels between 5:00 pm and 6:00 am, and NUV, but not with diurnal urine volume. Partial correlation coefficients showed that salt intake was a factor of the correlation between NUV and change in extracellular volume in the legs between 5:00 pm and 6:00 am. A multivariate logistic model showed that sleep duration and sodium clearance were independent predictive factors for nocturnal polyuria. CONCLUSIONS: Sodium intake correlates with diurnal leg edema and NUV in elderly men. These results provide evidence supporting sodium restriction as an effective treatment for nocturnal polyuria.
  • Keisuke Kiba; Yasunori Akashi; Motokiyo Yoshikawa; Yutaka Yamamoto; Akihide Hirayama; Kiyohide Fujimoto; Hirotsugu Uemura
    Research and reports in urology 12 569 - 575 2020 
    Purpose: The aim of this study was to compare the safety and efficacy of photoselective vaporization of the prostate (PVP) and transurethral enucleation with a bipolar system (TUEB). Patients and Methods: Patients who underwent PVP or TUEB surgery for lower urinary tract symptoms due to bladder outlet obstruction at our institution from September 2015 to May 2019 were retrospectively reviewed. A total of 83 patients (PVP: n=45, TUEB: n=38) who were available for follow-up at least 12 months after surgery were included. Preoperative characteristics, perioperative parameters, and postoperative outcomes-such as International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and complications-at 3, 6, and 12 months after surgery were compared between the two groups. Results: Although differences in age, IPSS, and QoL were not significant, a significantly greater prostate volume, lower Qmax, and greater PVR were noted in the TUEB group. In perioperative parameters, a significantly shorter operation time, less change in serum hemoglobin, fewer days of catheterization, and shorter length of stay were observed in the PVP group. As for postoperative outcomes, the IPSS storage subscore and PVR were significantly improved in the TUEB group. As complications, stress urinary incontinence was more frequently observed in the TUEB group, and urethral stricture was more common in the PVP group. Conclusion: The present data suggest that PVP and TUEB are efficient and safe surgical treatment options. Management of patients undergoing PVP in the perioperative period appears easy. Improvements of subjective and objective parameters were superior after TUEB than after PVP.
  • 転移性尿路上皮癌に対するペムブロリズマブの使用経験
    山本 豊; 西本 光寿; 野澤 昌弘; 明石 泰典; 喜馬 啓介; 橋本 士; 菊池 尭; 大関 孝之; 清水 信貴; 森 康範; 南 高文; 能勢 和宏; 吉村 一宏; 平山 暁秀; 植村 天受
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 57回 P97 - 3 2019/10 [Refereed]
  • Keisuke Kiba; Akihide Hirayama; Motokiyo Yoshikawa; Yutaka Yamamoto; Kazumasa Torimoto; Nobutaka Shimizu; Nobumichi Tanaka; Kiyohide Fujimoto; Hirotsugu Uemura
    Lower urinary tract symptoms 10 (3) 253 - 258 2018/09 
    OBJECTIVE: To investigate whether or not the leg fluid displacement observed when moving from the standing to recumbent position at bedtime reduces the hours of undisturbed sleep (HUS). METHODS: Men aged 50 years or older who were hospitalized for urological diseases were investigated. Body water evaluation was performed three times with a bioelectric impedance method: (i) 17:00, (ii) 30 min after (short-term), and (iii) waking up (long-term). A frequency volume chart was used to evaluate the status of nocturnal urine production, and the factors affecting HUS were investigated. RESULTS: A total of 50 patients (mean age: 68 years) were enrolled. Short-term changes in extracellular fluid (ECF in the legs showed a significant positive correlation with urine production per unit of time at the first nocturnal voiding (UFN/HUS) (r = 0.45, P = 0.01). In the comparison between patients who had <3 HUS vs. those who had ≥3 HUS, the <3 HUS group showed significantly greater short-term changes in leg fluid volume, night-time water intake (17:00-06:00), and UFN/HUS. Multivariate analysis to assess the risk factors for <3 HUS indicated UFN/HUS as a risk factor in the overall model, and short-term changes in leg ECF and night-time water intake as risk factors in the model that only considered factors before sleep. CONCLUSIONS: Nocturnal leg fluid displacement may increase urine production leading up to first voiding after going to bed, and consequently, induce early awakening after falling asleep.
  • Yutaka Yamamoto; Yasunori Akashi; Takahumi Minami; Masahiro Nozawa; Keisuke Kiba; Motokiyo Yoshikawa; Akihide Hirayama; Hirotsugu Uemura
    Case reports in urology 2018 1414395 - 1414395 2018 
    Introduction: The treatment strategy for castration-resistant prostate cancer (CRPC) has changed with the approval of several new agents. In 2011, abiraterone acetate was approved for the treatment of metastatic CRPC; however abiraterone is known to cause mineralocorticoid excess syndrome characterized by hypokalemia, fluid retention, and hypertension. We experienced two cases of grade 4 hypokalemia associated with abiraterone treatment. Case Presentation: Case 1: a 71-year-old male with metastatic CRPC presented with convulsive seizures two weeks after receiving abiraterone plus prednisone. The serum potassium level was 2.1mEq/l. We determined that convulsive seizure was caused by hypokalemia associated with abiraterone. Case 2: a 68-year-old male with metastatic CRPC presented with severe lethargy one month after receiving abiraterone plus prednisone. The serum potassium level was 1.7mEq/l and we concluded that severe lethargy was caused by hypokalemia associated with abiraterone. They were treated with potassium supplementation and increased prednisone following withdrawal of abiraterone. Discussion: The two patients had been on glucocorticoid therapy before abiraterone therapy. Prolonged administration of exogenous glucocorticoid can lead adrenocortical insufficiency and consequently reduce endogenous glucocorticoid production. This situation may increase the risk of abiraterone-induced mineralocorticoid excess. To reduce the risk of abiraterone-induced hypokalemia, evaluation of adrenocortical insufficiency is required.
  • Chie Matsushita; Kazumasa Torimoto; Daisuke Goto; Yosuke Morizawa; Keisuke Kiba; Masatake Shinohara; Akihide Hirayama; Norio Kurumatani; Kiyohide Fujimoto
    The Journal of urology 197 (1) 204 - 209 2017/01 
    PURPOSE: We objectively investigated the relationship between sleep quality/efficiency and factors associated with micturition using at-home electroencephalogram assessment. MATERIALS AND METHODS: Participants were recruited from among those enrolled in the Fujiwara-kyo Study, a community based longitudinal evaluation that began in Nara Prefecture, Japan, in 2007. Included participants were men at least 65 years old who woke up in the middle of the night/early morning at least 3 times per week with the urge to void. We evaluated lower urinary tract symptoms using the I-PSS and subjective sleep quality using the Pittsburgh Sleep Quality Index. Uroflowmetry and 3-day frequency volume charting measurements were also obtained. Electroencephalogram recordings were obtained during sleep to evaluate objective sleep quality. RESULTS: Final analysis included data from 47 participants. I-PSS-quality of life score and slow wave sleep time were independent predictors of good subjective sleep quality as determined by Pittsburgh Sleep Quality Index scores. Nocturnal urinary volume was an independent predictor of greater sleep efficiency. Maximum flow rate was an independent predictor of longer slow wave sleep time. CONCLUSIONS: In elderly men with nocturia, sleep quality is associated with lower urinary tract function. Higher subjective sleep quality is associated with longer slow wave sleep time and less severe lower urinary tract symptoms. Higher objective sleep quality is further associated with a higher urinary flow rate and lower nocturnal urinary volume.
  • Masatake Shinohara; Keisuke Kiba; Atsushi Yamada; Kinta Hatakeyama; Yasunobu Mita; Toshihisa Saka; Yoshihik Hirao
    Hinyokika kiyo. Acta urologica Japonica 62 (5) 265 - 9 0018-1994 2016/05 
    A 66-year-old man was referred to our hospital because of right leg pain. Computed tomography (CT) revealed multiple osteolytic changes. His serum prostate-specific antigen (PSA) level was increased to 77.83 ng/ml at the time of hospitalization. A prostate biopsy was performed, and histological examination results indicated poorly differentiated adenocarcinoma. Under the diagnosis of multiple bone metastasis of prostate cancer, androgen deprivation therapy was started. However, 1 month later, the patient was confused and lost appetite. Brain CT image demonstrated brain metastasis, and magnetic resonance image showed hydrocephalus. Although the patient underwent ventricular drainage because of a depressed level of consciousness, he died of primary disease complicated by pneumonia 3 months after the first visit. Perioperative cerebrospinal fluid cytological examination revealed adenocarcinoma cells. Therefore, a diagnosis of carcinomatous meningitis caused by prostate cancer metastasis was made.
  • Keisuke Kiba; Akihide Hirayama; Motokiyo Yoshikawa; Yutaka Yamamoto; Kazumasa Torimoto; Kiyohide Fujimoto; Hirotsugu Uemura
    Hinyokika kiyo. Acta urologica Japonica 62 (5) 243 - 8 0018-1994 2016/05 [Refereed]
     
    A total of 29 men 60 years and older (mean age 74 years) who complained at least once about nocturnal voiding and were diagnosed with nocturnal polyuria in the frequency volume chart (FVC) were enrolled in this study. Body water was measured by bioelectric impedance analysis just after lying down at 4 pm and after raising legs 30 minutes later. Nocturnal urine production was measured by FVC, and urine production per unit of time at first nocturnal voiding (urine volume at first nocturnal voiding/hours of undisturbed sleep (HUS) : UFN/HUS), urine production per unit of time during sleep (total nocturnal urine volume/hours of sleep : TNV/HS), etc was evaluated. Extra cellular water (ECW) of 0.19 l (4.0%) in legs was reduced caused by body position changing. There was a significant positive correlation between the amount of ECW in legs and UFN/HUS, TNV/HS (r＝0. 57, p＝0.001 ; r＝0. 38, p＝0.042, respectively). Moreover, UFN/HUS had a significant correlation with soft lean mass in legs, ECW in legs and daytime water intake. This study suggested that a change in leg fluids caused by a change in position results in increased urine production and decreased HUS.
  • Yutaka Yamamoto; Keisuke Kiba; Motokiyo Yoshikawa; Akihide Hirayama; Seiji Kunikata; Hirotsugu Uemura
    Research and reports in urology 8 225 - 231 2253-2447 2016 
    OBJECTIVE: The aim of this study was to evaluate the biochemical recurrence (BCR) in patients with high-risk prostate cancer (PCa) treated with radical prostatectomy (RP) or radiotherapy (RT) plus androgen deprivation therapy (ADT). METHODS: Subjects were patients with National Comprehensive Cancer Network-defined high-risk PCa treated with either RP or RT plus ADT. We calculated BCR-free survival in patients with those treatments and evaluated risk factor against BCR. RESULTS: A total of 114 patients, 71 RP and 43 RT plus ADT, were evaluated. A total of 59 and 20.9% of patients experienced BCR in the RP and RT treatment groups, respectively. The 5-year BCR-free survival probabilities improved significantly for patients who received RT compared to those who received RP (81.3 vs 37.3%, P<0.001). According to the number of risk factors, 59.2% of patients in the RP and 51.2% of patients in the RT treatment groups were classified with one risk factor (P<0.014). The 5-year BCR-free survival probabilities for patients treated with RP were 46.6 and 21.7% for one and multiple risk factors, respectively (P=0.008). On univariate analysis, only the number of risk factors had a significant impact on the risk of BCR. Meanwhile, there were no significant differences in the 5-year BCR-free survival probabilities between one and multiple risk factors in patients treated with RT. CONCLUSION: Among patients treated with RP, a marked heterogeneity existed in the oncological outcomes. Based on these findings, the number of risk factors should be emphasized to decide the optimal treatments for patients with high-risk PCa.
  • Fumiaki Hoshiyama; Hitoshi Momose; Keisuke Kiba; Ken Fujimoto; Takamasa Ono; Nobuo Oyama
    Hinyokika kiyo. Acta urologica Japonica 60 (8) 401 - 3 0018-1994 2014/08 
    A 37-year-old man visited our hospital with a chief complaint of sudden onset of right scrotal pain. Because spermatic cord torsion was suspected, an exploratory incision was made. There was no spermatic cord torsion, but an induration was palpated in a part of the right testis. Because a testicular tumor was strongly suspected, right high orchiectomy was performed. The histopathological diagnosis was a pT1 seminoma. Our experience with this case suggests that testicular tumor should be considered in the differential diagnoses of acute scrotum.
  • Yosuke Morizawa; Kazumasa Torimoto; Shunta Hori; Keisuke Kiba; Masatake Shinohara; Akihide Hirayama; Kiyohide Fujimoto
    Hinyokika kiyo. Acta urologica Japonica 60 (4) 189 - 93 0018-1994 2014/04 
    A 71-year-old man had been under treatment for nocturia with an anti-cholinergic agent at a urologic clinic for the last 2 years. Because the symptoms did not improve, he was referred to our hospital for treatment of urinary retention. Based on the findings of a neurological examination, we suspected the presence of a neurogenic bladder due to sacral lesions. Moreover, magnetic resonance imaging indicated tethered cord syndrome (TCS) due to spinal cord lipoma. He underwent surgical treatment for TCS, which improved storage function, but not voiding function. Generally speaking, we believe that early diagnosis of TCS facilitates early surgery that can prevent the development of neurogenic disorders. In the present case, if the neurological findings had been appropriately assessed and cystometry/urodynamic studies had been performed at an earlier stage, a prompt diagnosis could have been made and surgery could have been performed earlier as well. Although adult cases with TCS are rarely observed, TCS should be considered as one of the causes of intractable lower urinary tract symptoms.
  • Shinji Fukui; Keisuke Kiba; Masatake Shinohara; Tatsuo Yoneda; Kiyohide Fujimoto; Katsunori Yoshida; Yoshihiko Hirao
    Hinyokika kiyo. Acta urologica Japonica 56 (9) 513 - 6 0018-1994 2010/09 
    A 50-year-old woman visited our department for further examination of incidental bladder tumor detected by ultrasound at her health check. Cystoscopy demonstrated a submucosal tumor in the anterior wall of the urinary bladder. Magnetic resonance imaging revealed that the tumor had high intensity in T2- weighted images. The slightly-elevated serum level of dopamine and uptake image in the meta iodobenzyl granidine-scintigraphy test suggested that she might have ectopic pheochromocytoma in the urinary bladder. Partial cystectomy with extirpation of the tumor was performed. The histological diagnosis was schwannoma, which is rarely found in the urinary bladder.
  • 藤本 健; 喜馬 啓介; 星山 文明; 小野 隆征; 大山 信雄; 百瀬 均; 中農 勇; 平山 暁秀; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 101 (2) 476 - 476 2010

MISC

  • 転移性尿路上皮癌に対するペムブロリズマブの使用成績
    明石 泰典; 山本 豊; 安富 正悟; 橋本 士; 喜馬 啓介; 西本 光寿; 清水 信貴; 南 高文; 藤田 和利; 野澤 昌弘; 吉村 一宏; 平山 暁秀; 植村 天受  日本泌尿器科学会総会  109回-  PP25  -06  2021/12
  • 転移性尿路上皮癌に対するペムブロリズマブの使用成績
    明石 泰典; 山本 豊; 安富 正悟; 橋本 士; 喜馬 啓介; 西本 光寿; 清水 信貴; 南 高文; 藤田 和利; 野澤 昌弘; 吉村 一宏; 平山 暁秀; 植村 天受  日本泌尿器科学会総会  109回-  PP25  -06  2021/12
  • 気腫性腎盂腎炎にて腎摘除術が必要であったコントロール不良2型糖尿病の1例
    岸谷 讓; 末吉 功治; 明石 泰典; 喜馬 啓介; 山本 豊; 平山 暁秀; 若狭 則子; 太田 善夫  糖尿病  63-  (7)  509  -509  2020/07
  • Keisuke Kiba; Akihide Hirayama; Motokiyo Yoshikawa; Yutaka Yamamoto; Kazumasa Torimoto; Nobutaka Shimizu; Nobumichi Tanaka; Kiyohide Fujimoto; Hirotsugu Uemura  Lower urinary tract symptoms  10-  (3)  253  -258  2018/09
  • 神経疾患を有さない高齢男性におけるリドカイン注入pressure flow studyの臨床的意義
    喜馬 啓介; 明石 泰典; 吉川 元清; 山本 豊; 平山 暁秀; 植村 天受  日本排尿機能学会誌  28-  (1)  241  -241  2017/09
  • リドカイン注入pressure flow study(LPFS)による高齢男性の排尿機能の変化について
    喜馬 啓介; 吉川 元清; 山本 豊; 平山 暁秀; 植村 天受  日本泌尿器科学会総会  105回-  OP31  -3  2017/04
  • 喜馬 啓介; 平山 暁秀; 吉川 元清; 山本 豊; 鳥本 一匡; 藤本 清秀; 植村 天受  泌尿器科紀要  62-  (5)  243  -248  2016/05
  • 体位変換による体水分量変化が就眠後第一排尿までの時間(HUS)に与える影響
    喜馬 啓介; 吉川 元清; 山本 豊; 清水 信貴; 平山 暁秀; 国方 聖司; 藤本 清秀; 植村 天受  日本泌尿器科学会総会  104回-  OP  -138  2016/04
  • 夜間睡眠中の体水分変化が夜間尿量へ及ぼす影響の検討 電気インピーダンス法による解析
    喜馬 啓介; 平山 暁秀; 吉川 元清; 山本 豊; 国方 聖司; 藤本 清秀; 植村 天受  泌尿器科紀要  62-  (4)  216  -216  2016/04
  • 吉川 元清; 喜馬 啓介; 山本 豊; 平山 暁秀; 植村 天受  Japanese Journal of Endourology  28-  (3)  236  -236  2015/11
  • 臥位による下肢水分移行が夜間尿量へ及ぼす影響の検討 電気インピーダンス法による解析
    喜馬 啓介; 平山 暁秀; 吉川 元清; 山本 豊; 國方 聖司; 清水 信貴; 鳥本 一匡; 藤本 清秀; 植村 天受  日本排尿機能学会誌  26-  (1)  179  -179  2015/09
  • 初期治療として夜尿アラーム療法を行った小児夜尿症の治療成績
    堀 俊太; 青木 勝也; 森澤 洋介; 喜馬 啓介; 篠原 雅岳; 三宅 牧人; 穴井 智; 鳥本 一匡; 平山 暁秀; 田中 宣道; 藤本 清秀; 吉田 克法; 平尾 佳彦  泌尿器科紀要  58-  (7)  374  -374  2012/07

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