Kimata Naoki, Tsuchiya Ken, Akiba Takashi, Nitta Kosaku
Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Blood Purif. 2015;40(4):275-9. doi: 10.1159/000441573. Epub 2015 Nov 17.
Japanese patients undergoing dialysis have an extremely low mortality rate compared with those in the United States and Europe. As shown in the Dialysis Outcomes 38; Practice Patterns Study (DOPPS), certain features of dialysis treatment, such as single treatment time and amount of blood flow, are unique to Japan, but factors contributing to the low mortality risk are unclear. Although DOPPS is a multi-country prospective cohort study, the study results may not entirely reflect the real trend in Japan because the number of Japanese institutions participating in the study is small.
In this article, we review the data reported for Japan and other countries and reveal country-specific differences, particularly in patient age distribution and duration of dialysis.
The mean age of prevalent dialysis patients is rising every year in Japan, and the proportion of patients undergoing dialysis for long periods of time is also increasing. In addition, the proportion of dialysis patients with diabetes, one of the primary diseases, has increased to a level similar to that observed in Western countries. However, no significant decline in the crude death rate among prevalent dialysis patients has been observed in Japan, presumably because of technological advances in dialysis treatment, but further studies are needed to elucidate the contributing factors.
与美国和欧洲的患者相比,接受透析治疗的日本患者死亡率极低。如《透析结果与实践模式研究》(DOPPS)所示,透析治疗的某些特征,如单次治疗时间和血流量,在日本独具特色,但导致低死亡风险的因素尚不清楚。尽管DOPPS是一项多国前瞻性队列研究,但由于参与研究的日本机构数量较少,研究结果可能无法完全反映日本的真实趋势。
在本文中,我们回顾了日本和其他国家报告的数据,并揭示了各国之间的差异,特别是在患者年龄分布和透析时长方面。
在日本,透析患者的平均年龄逐年上升,长期接受透析治疗的患者比例也在增加。此外,主要疾病之一糖尿病患者在透析患者中的比例已上升至与西方国家相近的水平。然而,在日本,透析患者的粗死亡率并未显著下降,推测这是由于透析治疗技术的进步,但仍需进一步研究以阐明其影响因素。