Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
J Nephrol. 2022 Apr;35(3):719-724. doi: 10.1007/s40620-021-01140-9. Epub 2021 Oct 12.
Disaster-related stress can increase blood pressure and the incidence of cardiovascular diseases. However, the role of massive disasters in the development of end-stage kidney disease (ESKD) remains unknown. We investigated the incidence and different causes of dialysis initiation in patients with chronic kidney disease in a city affected by the Great East Japan Earthquake.
This was a single-center, retrospective observational study. All patients who initiated or were treated with dialysis at Kesennuma City Hospital between 2007 and 2020 were enrolled. The year of dialysis initiation was retrospectively determined based on the initiation date. The causative renal diseases that led to the need for dialysis initiation were divided into four groups: diabetic nephropathy, hypertensive renal disease, glomerulonephritis, and others.
Age at dialysis initiation differed significantly among the four groups (p = 0.0262). There was a significant difference in the numbers of the four groups before and after the Great East Japan Earthquake (p = 0.0193). The age of hypertensive renal disease patients was significantly higher than those of patients with diabetic nephropathy (p = 0.0070) and glomerulonephritis (p = 0.0386) after the disaster. The increasing number of dialysis initiations after the Great East Japan Earthquake appeared to be associated with changes in hypertensive renal diseases; the number peaked after 10 years.
There was an increase in the number of dialysis initiations, especially caused by hypertensive renal diseases, for up to 10 years after the Great East Japan Earthquake.
与灾难相关的压力会导致血压升高和心血管疾病的发生。然而，大规模灾难在终末期肾病（ESKD）发展中的作用尚不清楚。我们调查了在东日本大地震受灾城市中慢性肾脏病患者发生透析的发生率和不同原因。
这是一项单中心、回顾性观察性研究。所有在气仙沼市医院于 2007 年至 2020 年期间开始或接受透析治疗的患者均被纳入研究。根据开始透析的日期回顾性确定开始透析的年份。导致需要开始透析的病因性肾脏疾病分为四组：糖尿病肾病、高血压性肾病、肾小球肾炎和其他。
四组患者的透析起始年龄差异有统计学意义（p=0.0262）。东日本大地震前后四组患者的数量存在显著差异（p=0.0193）。高血压性肾病患者的年龄明显高于糖尿病肾病（p=0.0070）和肾小球肾炎（p=0.0386）患者。东日本大地震后透析起始数量的增加似乎与高血压性肾病的变化有关；数量在 10 年后达到峰值。
东日本大地震后，透析起始数量增加，尤其是由高血压性肾病引起的透析起始数量增加，持续了 10 年。
