Protocol for a Prospective Cohort Study Investigating Premature Aging Phenotypes and Associated Outcomes in Maintenance Hemodialysis Patients: the Kumamoto Hemodialysis Cohort Study

抄録

Background: The incidence of end-stage kidney disease (ESKD) caused by chronic kidney disease is increasing worldwide. Patients with ESKD often exhibit significant premature aging and have a higher risk of premature mortality than the general population. Here, we conducted a prospective cohort study, the Kumamoto Hemodialysis Cohort Study, to explore the mechanisms of the premature aging phenotype exhibited by these patients using biological markers and highly detailed clinical information in a real-world setting.

Methods: This multicenter prospective cohort study targeted adult outpatients receiving maintenance hemodialysis therapy in Kumamoto Prefecture, Japan. After enrollment, the patients were followed up for 10 years. Data were collected from the electronic medical records of medical facilities that participated retrospectively and prospectively from January 1, 2017. Clinical information was collected from electronic medical records, medical chart reviews, and patient-completed questionnaires. Serum and plasma samples were collected every 3 years. Thus far, 1,241 patients have been enrolled in this study, and we found the median age of the participants was 69 years, and 67.5% were male. Among the primary causes of kidney failure, diabetic nephropathy accounted for 38.6% of all cases, followed by glomerulonephritis (27.2%) and nephrosclerosis (9.9%). The median hemodialysis vintage was 5.8 years.

Conclusion: This study contributes to the characterization of a premature aging phenotype together with morbidity and mortality of patients with ESKD, thereby providing insights into the prevention of the onset of premature aging-related diseases in patients receiving maintenance hemodialysis therapy.