2020 Volume 53 Issue 12 Pages 579-632
The annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) was conducted for 4,487 dialysis facilities at the end of 2019 among which 4,411 facilities (98.3%) responded to the facility survey and 4,238 facilities (94.5%) responded to the patient survey. The number of chronic dialysis patients in Japan continues to increase every year; it has reached 344,640 at the end of 2019 and the prevalence ratio of dialysis patients was 2,732 per million population. The mean age of the prevalent dialysis patients in the patient survey was 69.09 years. Diabetic nephropathy was the most common primary disease of the prevalent dialysis patients (39.1%), followed by chronic glomerulonephritis (25.7%) and nephrosclerosis (11.4%). The number of incident dialysis patients during 2019 was 40,885; it increased by 417 from 2018. The average age was 70.42 years and diabetic nephropathy (41.6%) was the most common cause in incident dialysis patients. Nephrosclerosis became the second cause followed by glomerulonephritis. As 34,642 patients died in 2019, the crude annual mortality rate was 10.1%. The three major causes of death were heart failure (22.7%), infectious disease (21.5%) and malignancy (8.7%). The patients treated by hemodiafiltration (HDF) have been increasing in number rapidly since 2012. The number has reached 144,686 by the end of 2019, which accounted for 42.0% of all dialysis patients. The number of peritoneal dialysis (PD) patients was 9,920 in 2019, which has slightly increased since 2017. The combination or hybrid therapy with hemodialysis (HD) or HDF was given to 19.2% of PD patients. Home HD therapy was conducted in 760 patients at the end of 2019; it increased by 40 from 2018. It was 10 years since the previous survey in 2009 that the present status of CKD-MBD treatment was comprehensively surveyed in 2019. Clinical efficacy of newly introduced medicines during this period and the influence of the CKD-MBD guidelines revised in 2012 should be further analyzed. These analyses would be the basis for the next revision of the CKD-MBD guidelines, and it could provide deeper therapeutic insights for CKD-MBD.
