An Overview of Dialysis Treatment in Japan.

Nakai, Shigeru; Shinzato, Takahiro; Sanaka, Tsutomu; Kikuchi, Kenjiro; Kitaoka, Tateki; Shinoda, Takeshi; Yamazaki, Chikao; Sakai, Rumi; Omori, Hiroyuki; Morita, Osamu; Iseki, Kunitoshi; Kubo, Kazuo; Tabei, Kaoru; Masakane, Ikuto; Fushimi, Kiyohide; Akiba, Takashi

doi:10.4009/jsdt.34.1121

Cited by 56 publications

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“…15 The percentage of patients with diabetic nephropathy in the KAREN Study was similar to that of the Japanese Society for Dialysis Therapy (JSDT) Survey. 1 However, the proportion of patients with chronic glomerulonephritis in the KAREN Study was lower, and the percentage of patients with hypertensive nephrosclerosis in the KAREN Study was higher, than those in the JSDT Survey. 1 In the current study, we identified causes of ESRD using information from medical records.…”

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confidence: 93%

“…1 However, the proportion of patients with chronic glomerulonephritis in the KAREN Study was lower, and the percentage of patients with hypertensive nephrosclerosis in the KAREN Study was higher, than those in the JSDT Survey. 1 In the current study, we identified causes of ESRD using information from medical records. The most common reason for classifying patients as unknown etiology was insufficient information regarding whether onset of proteinuria preceded that of hypertension.…”

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confidence: 93%

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Cardiovascular Risk Factors in Hemodialysis Patients: Results from Baseline Data of Kaleidoscopic Approaches to Patients with End-stage Renal Disease Study

Ohsawa

Kato

Itai

et al. 2005

Journal of Epidemiology

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BACKGROUND: The prevalence of cardiovascular risk factors and the prevalence of comorbidities in adult hemodialysis patients in Japan are not fully understood. METHODS: In “Kaleidoscopic Approaches to Patients with End-stage Renal Disease Study” (The KAREN Study, 2003), trained research stuff examined 1,214 adult hemodialysis patients (mean age, 61.2 years; 779 males and 435 females) of 1,506 patients in northern areas of Iwate Prefecture. Cardiovascular risk factors and the prevalence of comorbidities in hemodialysis patients were compared with those in the general population using direct age-adjustment methodology and standardized morbidity ratios (SMRs). RESULTS: In hemodialysis patients, common causes of end-stage renal disease were chronic glomerulonephritis (29.8%), diabetic nephropathy (24.5%), and other diseases. Prevalence and SMR of myocardial infarction were 5% and 9.6, respectively, and those of stroke were 13% and 5.7. The prevalences of hypertension and diabetes mellitus were 87% and 29%, respectively. Mean systolic blood pressure and mean diastolic blood pressure were 155 mmHg and 85 mmHg, respectively. Mean levels of total serum cholesterol, high-density lipoprotein cholesterol, and albumin in patients with end-stage renal disease were lower than those of the general population (160.6 vs. 203.3 mg/dL, 48.5 vs. 59.7 mg/dL, and 3.7 vs. 4.4 g/dL, respectively). Mean levels of C-reactive protein were higher than those of the general population (3.80 vs. 1.16 mg/L). CONCLUSION: Hemodialysis patients have a high prevalence of cardiovascular risk factors and comorbidities. Levels of nutrition-related markers were lower, and C-reactive protein levels were higher, in hemodialysis patients than in the general population.

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confidence: 93%

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confidence: 93%

Cardiovascular Risk Factors in Hemodialysis Patients: Results from Baseline Data of Kaleidoscopic Approaches to Patients with End-stage Renal Disease Study

Ohsawa

Kato

Itai

et al. 2005

Journal of Epidemiology

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“…Study of the United States Renal Disease System (USRDS) and European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) registries shows that the prevalence of diagnosed Fabry disease in ESRDpatients is 0.0167% and 0.0188%, respectively (7,8). Fabry disease was not reported as the primary disease for those who initiated dialysis therapy in 1999 in the annual overview issued by the Japanese Society of Dialysis Therapy (9). However, the primary disorder for 4, 1 85 of 30,438 Japanese patients who initiated dialysis therapy in 1 999 is not specified (9).…”

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confidence: 99%

“…Fabry disease was not reported as the primary disease for those who initiated dialysis therapy in 1999 in the annual overview issued by the Japanese Society of Dialysis Therapy (9). However, the primary disorder for 4, 1 85 of 30,438 Japanese patients who initiated dialysis therapy in 1 999 is not specified (9). Furthermore, a recent Japanese regional study demonstrated that 6 of 5 14 (1.2%) male chronic hemodi-Fabry Disease with Few Clinical Symptoms alysis patients were enzymatically diagnosed as having Fabry disease (10).…”

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confidence: 99%

Fabry Disease with Few Clinical Signs and Symptoms.

et al. 2002

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Wedescribe a 25-year-old man with Fabry disease who remained undiagnosed until progressive renal involvement had begun, because of few clinical signs or symptoms except intermittent acroparesthesia. He had non-nephrotic proteinuria and normal renal function. Renal biopsy revealed focal and segmental glomerular sclerosis with vacuolated podocytes. Electron microscopy demonstrated characteristic lamellated bodies. a-Galactosidase A (oc-galA) activity was markedly decreased. Early diagnosis of Fabry disease is becoming important because of the prospect of recombinant oc-galA replacement therapy. Careful history taking, physical examinations, and renal histology with electron microscopyare essential for the diagnosis in the course of the disease. (Internal Medicine 41: 983-985, 2002)

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“…Furthermore, the hazard ratio (RR) for death was reduced by 23% when treatment time was increased to 4.5-4.9 h/session as compared to the reference treatment time 4.0-4.4 h/session. In Japan, treatment time longer than 4.5 h was associated with reduced RR death up to approximately 6 h and short dialysis times increased the risk of death over the reference of 4.5 h [5] . The recent DOPPS report showed that Europe and Japan have significantly longer (p !…”

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Major Difficulties the US Nephrologist Faces in Providing Adequate Dialysis

Díaz-Buxó

Crawford-Bonadio²

2006

Blood Purif

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Aim: To identify the major difficulties nephrologists in the US face in providing adequate dialysis. Methods: To identify the perceived obstacles to achieving adequate dialysis in the US, 30 clinical support specialists responsible for nursing education and training were polled. Their responses together with those found in the recent literature were summarized and analyzed. Results: The obstacles identified fell into the following major categories: (1) economic; (2) personnel shortage; (3) education, and (4) cultural. The principal specific difficulties identified in providing adequate dialysis were the provision of sufficient time and frequency of dialysis, adequate volume control and vascular and peritoneal access. Conclusions: The obstacles we currently face are serious but can be conquered through better understanding of the problems and education of professionals, patients and payers. The simple improvement in two specific areas, the creation of more native arteriovenous fistulae and growth of home dialysis, are identified as the highest priorities to overcome these obstacles.

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An Overview of Dialysis Treatment in Japan.

Abstract: protein catabolic rate of less than 0.9g/kg/day or more than 1.5g/kg/day, and a low creatinine generation rate were risk factors in the 6-year mid-term prognosis for hemodialysis patients.

Cited by 56 publications

References 0 publications

Cardiovascular Risk Factors in Hemodialysis Patients: Results from Baseline Data of Kaleidoscopic Approaches to Patients with End-stage Renal Disease Study

Cardiovascular Risk Factors in Hemodialysis Patients: Results from Baseline Data of Kaleidoscopic Approaches to Patients with End-stage Renal Disease Study

Fabry Disease with Few Clinical Signs and Symptoms.

Major Difficulties the US Nephrologist Faces in Providing Adequate Dialysis

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