Current status of blood purification in critical care in Japan.

In order to clarify the present status of blood purification therapy (BPT) in critical care in Japan, questionnaires investigating all the patients who were treated with BPT in 2005 were distributed. The number of patients who received BPT was 9,795, and the number of BPT performed was 11,623. The number and types of BPT treatment given are: continuous hemodiafiltration (CHDF)/hemofiltration (HDF) 5,443 (50.3%); continuous hemofiltration (CHF) 812 (7.5%); continuous hemodialysis (CHD) 877 (8.1%); simple plasma exchange 898 (8.3%); direct hemoperfusion (DHP) with polymyxin-B-coated textile (PMX-DHP) 1,625 (15.0%); DHP with activated carbon (AC-DHP) 129 (1.2%). The survival rates of patients with continuous therapies (CHDF, CHF, CHD) were as follows: multiple organ failure with CHDF 35%; sepsis with CHDF 65%; acute hepatic failure with CHDF 50%; acute renal failure with CHDF 66%; acute drug intoxication with AC-DHP 79%. In conclusion, continuous therapies such as CHDF, CHF and CHD were the most popular modes (> 65%) of BPT in Japan. The worst survival rate among diseases in critical care was found in multiple organ failure patients. The best survival rate was in those who suffered from acute renal failure.