<scp>J</scp>apanese<scp>S</scp>ociety for<scp>D</scp>ialysis<scp>T</scp>herapy<scp>C</scp>linical<scp>G</scp>uideline for “Maintenance Hemodialysis: Hemodialysis Prescriptions”

Watanabe, Yoshihiko; Kawanishi, Hideki; Suzuki, Kazutoshi; Nakai, Shigeru; Tsuchida, Kenji; Tabei, Kaoru; Akiba, Takashi; Masakane, Ikuto; Takemoto, Yoshiaki; Tomo, Tadashi; Itami, Noritomo; Komatsu, Yasuhiro; Hattori, Motoshi; Mineshima, Michio; Yamashita, Akihiro; Saitō, Akira; Naito, Hisao; Hirakata, Hideki; Murata, Jun

doi:10.1111/1744-9987.12294

Cited by 93 publications

(94 citation statements)

References 192 publications

(226 reference statements)

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“…Consequently, HPM dialyzers have been the subject of major research to ameliorate comorbidities and improve patient outcomes. Unlike other countries, HPM dialyzers have been adopted in Japan, and are recommended for good outcomes in HD patients by the JSDT [8]. Japanese HD patients now undergo dialysis using high-flux membranes in an overwhelming 97% of cases, and 11.4% use protein-permeable membranes with β 2 MG clearance >70 mL/min [25].…”

Section: Discussionmentioning

confidence: 99%

“…The HPM concept, therefore, comprises all 3 characteristics: (1) high hydraulic permeability, (2) high solute permeability especially for “middle molecules,” and (3) high biocompatibility [7]. The Japanese Society for Dialysis Therapy (JSDT) guidelines recommend the use of HPM dialyzers because they have the potential to improve patients' prognosis and reduce dialysis-related complications, and are thus considered for use in dialysis therapy [8]. There are 7 types of HPM dialyzers in Japan: cellulose triacetate (CTA), ethylene vinyl alcohol (EVAL), polyacrylonitrile (PAN), polyester polymer alloy (PEPA), polyethersulfone (PES), polymethylmethacrylate (PMMA), and polysulfone (PS) [9].…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2017

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Background: Little information is available regarding the type of dialyzer which results in good prognosis. This study is aimed at investigating the association between 7 types of dialyzers and 2-year mortality. Methods: We conducted a cohort study using data from a nationwide registry of the Japanese Society for Dialysis Therapy. Subjects were 136,676 patients on maintenance hemodialysis (HD) between 2009 and 2011 who underwent maintenance HD for at least 2 years and were treated with one of the following 7 types of high-performance membrane dialyzers: cellulose triacetate (CTA), ethylene vinyl alcohol (EVAL), polyacrylonitrile (PAN), polyester polymer alloy (PEPA), polyethersulfone (PES), polymethylmethacrylate (PMMA), and polysulfone (PS). Cox regression was used to estimate the association between baseline dialyzers and all-cause 2-year mortality, adjusting for potential confounders. Results: Data were adjusted using basic factors, with PS as a reference group, and the hazard ratio (HR) was significantly higher in CTA, PMMA, PAN, and EVAL groups. Further data adjustment for Kt/V yielded the same results as were obtained from data adjusted for basic factors. After further adjustment for nutrition- and inflammation-related factors, HR was significantly lowered for the PES and PMMA groups compared with the PS group (HR 0.88; 95% CI 0.82-0.94 and HR 0.84 95% CI 0.76-0.93, respectively). After propensity score matching, HR for the PES and PMMA groups was significantly lowered compared with the PS group. Conclusions: The use of different membrane types may affect mortality. Further long-term prospective studies are needed to clarify whether the PES and PMMA membranes can improve prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…Many DOPPS studies have sought to clarify the factors related to the differences in survival. The recent JSDT Clinical Guideline for "Maintenance HD: Hemodialysis Prescription" addresses primarily dialysis dose, dialysis time, removal of β2-microglobulin, and optimization of dry weight, but not the selection of dialysate composition [7].…”

Section: Introductionmentioning

confidence: 99%

Dialysate Calcium Concentration below 3.0 mEq/L Is Not Associated with Improved Outcomes in the Japanese Dialysis Outcomes and Practice Patterns Study

Iseki

Henn

Nomura

et al. 2018

Nephron

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Background: Abnormal chronic kidney disease-mineral and bone disorder (CKD-MBD) markers have been associated with adverse outcomes in hemodialysis (HD) patients. Dialysate calcium concentration (D-Ca) likely influences serum calcium and phosphorus levels. Optimal D-Ca level remains unclear. We hypothesized that higher D-Ca is associated with cardiovascular events and mortality among Japanese HD patients. Methods: Enrollment data of chronic HD patients in the prospective observational study JDOPPS, phases 1–5 (1999–2015), provided exposures and covariates. All-cause mortality, non-arrhythmic cardiovascular events (NonAR-CVE), or their composites were analyzed by D-Ca, and divided into 2.5, 2.75, and 3.0 mEq/L. To minimize confounding by indication, analyses were restricted to facilities in which at least 90% of patients received the same D-Ca prescription. Association of D-Ca level with outcomes was evaluated in Cox models stratified by phase and accounting for facility clustering. Covariates describing patient demographics, comorbidities, laboratory values, CKD-MBD therapy, and facility attributes provided adjustment. Results: Of 9,201 patients included, 25.0% had D-Ca of 2.5 mEq/L; 6.8% D-Ca 2.75; and 68.2% D-Ca 3.0. Median follow-up time was 2.03 years. D-Ca was not associated with all-cause mortality, with hazards ratios for 2.5 vs. 3.0 mEq/L of 0.90 and 95% CI (0.73–1.11), nor with other outcomes. One effect modification occurred, protective for lower D-Ca on NonAR-CVE in the absence of cardiovascular comorbidities (p = 0.032), although corresponding D-Ca effects were not significant after multiple comparisons adjustment (p = 0.261 [D-Ca 2.5] and 0.125 [D-Ca 2.75]). Conclusion: Lowering D-Ca level below 3.0 mEq/L seems not to have a meaningful effect on patient outcomes.

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“…If other significant coronary stenotic lesions were detected and deemed likely to induce AMI in the near future, other PCIs were performed during the same procedure. Exclusion criteria included out-of-hospital cardiac arrest and renal dysfunction on dialysis 12 . This study was approved by the Ethics Committee of Showa University.…”

Section: Patientsmentioning

confidence: 99%

Thrombomodulin can Predict the Incidence of Second Events in Patients with Acute Myocardial Infarction

遼太

Kosaki

2017

Showa Univ J Med Sci

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: Biomarkers of atherothrombosis can predict the risk of cardiovascular events. However, it is dif cult to predict second adverse events using these biomarkers at the point in time when the rst cardiovascular event occurs. Therefore, we evaluated atherothrombosis-related biomarkers to determine their associations with prognosis after percutaneous coronary intervention PCI in acute myocardial infarction AMI patients. A total of 309 AMI patients were enrolled in this study. The patients had undergone successful coronary interventions and the levels of various atherothrombosis-related biomarkers were assessed within the rst postoperative hour. Biomarkers other than those assessed by routine biochemical tests were analyzed, including defined endothelial cell damage markers such as thrombomodulin TM , in ammatory markers such as C-reactive protein CRP , and coagulation and fibrinolysis system markers such as D-dimer, prothrombin fragment F1 2 F1 2 and plasminogen activator inhibitor-1 PAI-1 . Major adverse cardiac events MACEs occurred in 98 patients during the follow-up period 872.6 579.8 days . Multivariate analysis revealed that clinical parameters such as decreased levels of left ventricular ejection fraction and elevated levels of brain natriuretic peptide, hemoglobin A1c and TM were signi cantly associated with MACEs. The association between TM and MACEs was especially high OR : 3.65, 95 CI ; 1.75-7.68 . Neither dyslipidemia, hypertension, smoking, advanced age, a history of cardiac events nor the type of AMI were associated with MACEs. TM is independently associated with MACEs and may be predictive of second events following PCI in patients with AMI.

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JapaneseSociety forDialysisTherapyClinicalGuideline for “Maintenance Hemodialysis: Hemodialysis Prescriptions”

Cited by 93 publications

References 192 publications

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

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

Dialysate Calcium Concentration below 3.0 mEq/L Is Not Associated with Improved Outcomes in the Japanese Dialysis Outcomes and Practice Patterns Study

Thrombomodulin can Predict the Incidence of Second Events in Patients with Acute Myocardial Infarction

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