High-Performance Membrane Dialyzers and Mortality in Hemodialysis Patients: A 2-Year Cohort Study from the Annual Survey of the Japanese Renal Data Registry

Abe, Masanori; Hamano, Takayuki; Wada, Atsushi; Nakai, Shigeru; Masakane, Ikuto

doi:10.1159/000478032

Cited by 31 publications

(25 citation statements)

References 39 publications

(44 reference statements)

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“…One characteristic feature of dialysis prescriptions in HD and HDF in Japan have been rather protein permeable than the rest of the world. JRDR has published important reports about the advantages of this characteristic on patient survival [14][15][16]. We expect to release further information on dialysis prescriptions after further analysis of the results of the 2017 survey.…”

Section: Resultsmentioning

confidence: 99%

Annual dialysis data report 2017, JSDT Renal Data Registry

et al. 2019

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The annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) was conducted for 4413 dialysis facilities at the end of 2017; among which 4360 facilities (98.8%) responded to the facility questionnaire, and 4188 (94.9%) responded to the patient questionnaire. The response rate of the 2017 survey was comparable with the past, even though it was the third year after the new anonymization method. The number of chronic dialysis patients in Japan continues to increase every year; it has reached 334,505 at the end of 2017. The mean age was 68.43 years. The prevalence rate was 2640 patients per million population. Diabetic nephropathy was the most common primary disease among the prevalent dialysis patients (39.0%), followed by chronic glomerulonephritis (27.8%) and nephrosclerosis (10.3%). The rate of diabetic nephropathy and nephrosclerosis has been increasing year by year, whereas that of chronic glomerulonephritis was declining. The number of incident dialysis patients during 2017 was 40,959; it has remained stable since 2008. The average age was 69.68 years and diabetic nephropathy (42.5%) was the most common cause in the incident dialysis patients. These patients caused by diabetes did not change in number for recent several years. Further, 32,532 patients died in 2017; the crude mortality rate was 9.8%. The patients treated by hemodiafiltration (HDF) have been increasing rapidly from the revision of medical reimbursement for HDF therapy in 2012. It has attained 95,140 patients at the end of 2017, which were 18,304 greater than that in 2016. The number of peritoneal dialysis (PD) patients was 9090 in 2017, which had been slightly decreasing since 2014. Further, 19.4% of PD patients treated in the combination of hemodialysis (HD) or HDF therapy (hybrid therapy). And 984 patients were treated by home HD therapy at the end of 2017; it increased by 49 from 2016. Trial registration: JRDR was approved by the ethical committee of JSDT (approval number 1-3) and has been registered in "University hospital Medical Information Network (UMIN) Clinical Trials Registry" as a clinical trial ID of UMIN000018641 at 8th August 2015. https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000021578 (Accessed 31 July 2019).

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Section: Resultsmentioning

confidence: 99%

Annual dialysis data report 2017, JSDT Renal Data Registry

et al. 2019

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“…The Geriatric Nutritional Risk Index (GNRI), normalized protein catabolic rate (nPCR), and percent creatinine generation rate (%CGR) were calculated for each subject to assess the nutritional status [11,12]. The dose of dialysis was measured using the single-pool Kt/V for urea (Kt/V) [12]. Serum carnitine levels were determined by enzyme cycling methods, as described previously [13].…”

Section: Parameters Measuredmentioning

confidence: 99%

Prevalence of Carnitine Deficiency and Decreased Carnitine Levels in Patients on Hemodialysis

et al. 2019

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Background: Patients on hemodialysis (HD) are known to be at risk of carnitine deficiency. The aims of this study were to investigate the prevalence of carnitine deficiency in patients on dialysis and to compare the likelihood of a reduction in the serum carnitine level on HD with that on hemodiafiltration (HDF). Methods: The prevalence of carnitine deficiency, defined as a serum free carnitine level < 20 μmol/L, and that of carnitine insufficiency, defined as an acyl/free carnitine ratio > 0.4, was investigated in 150 patients on dialysis. The reduction rate of serum carnitine was then compared between HD and HDF. Results: The prevalence of carnitine deficiency and that of carnitine insufficiency was 25.3 and 86.7%, respectively. Patients at high risk of carnitine deficiency accounted for 64.7%. Multivariate regression identified an association of duration of dialysis with the free serum carnitine level. The reduction rates of serum free carnitine in HD and HDF were 64 ± 4 and 75 ± 7%, respectively (p < 0.0001). Conclusion: The prevalence rates of carnitine deficiency and carnitine insufficiency were high in patients on dialysis. The serum carnitine reduction rate was greater with HDF than with HD.

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“…Recently, Abe et al investigated the association between seven types of dialyzers and mortality using data from a nationwide registry of the Japanese Society for Dialysis Therapy [27,28]. In Abe et al's articles, data were adjusted using basic factors, dialysis dose, nutrition-and inflammation-related factors, with PS as a reference group, and the hazard ratio was significantly lower in the PMMA group compared with the PS group.…”

Section: Discussionmentioning

confidence: 99%

The clinical evaluation of novel polymethyl methacrylate membrane with a modified membrane surface: a multicenter pilot study

et al. 2018

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Background: Polymethyl methacrylate (PMMA) membranes have the unique property of adsorption, which can remove medium-and large-weight molecular substances that cannot be removed by normal hemodialysis and hemodiafiltration. Filtryzer® NF (NF) is a newly developed PMMA membrane that suppresses platelet adhesion on the membrane surface and retains an adsorption property. NF is expected to improve inflammatory conditions and clinical symptoms in hemodialysis patients compared with conventional PMMA membranes.Methods: Thirty-seven maintenance hemodialysis patients treated with polysulfone (PS) membranes and who had detectable chronic inflammation were enrolled into the study. The patients were randomly allocated into the NF and PS groups and observed for 1 year. C-reactive protein (CRP) values were measured as the primary endpoint. Nutrition, blood cell count, and dialysis itchiness were evaluated as secondary endpoints.Results: Significant differences in CRP values were not found between the NF and PS groups. In the PS group, the creatinine generation rate (%CGR) and platelet count, which were included in nutrition and blood cell count, respectively, significantly decreased after 6 and 9 months compared with the start of study, but these parameters did not significantly change in the NF group within 1 year. Dialysis itchiness in the NF group was significantly improved compared with the PS group after 9 months.Conclusions: Our results showed that a new PMMA membrane, NF, has a potential to maintain nutritional conditions and the platelet counts and improve dialysis itchiness.Trial registration: This study is retrospectively registered with the Clinical Trials Registry of the University Hospital Medical Information Network on February 17, 2015 (registration ID, UMIN000016567).

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High-Performance Membrane Dialyzers and Mortality in Hemodialysis Patients: A 2-Year Cohort Study from the Annual Survey of the Japanese Renal Data Registry

Cited by 31 publications

References 39 publications

Annual dialysis data report 2017, JSDT Renal Data Registry

Annual dialysis data report 2017, JSDT Renal Data Registry

Prevalence of Carnitine Deficiency and Decreased Carnitine Levels in Patients on Hemodialysis

The clinical evaluation of novel polymethyl methacrylate membrane with a modified membrane surface: a multicenter pilot study

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