An overview of dialysis treatment in Japan (as of Dec. 31, 1998)
Keywords:
logistic regression analysis
2000 Volume 33 Issue 1 Pages 1-27
Details
2000 Volume 33 Issue 1 Pages 1-27
In 1998, the Japanese Society for Dialysis Therapy conducted a statistical survey of 3, 095 facilities in Japan and received replies from 3, 085 facilities (99.67%). As of the end of 1998, there were 185, 322 dialysis patients in Japan, an increase of 9, 334 patients (5.3%) over a year from the end of 1998. The gross mortality rate was 9.2%, the same as the previous year.
The mean age of the patients who started their dialysis therapy in 1998 was 62.7±13.9 years old (±S. D.). This shows that the age of dialysis patients was higher than the previous year. During the year 1998, the ratio of primary disease among patients beginning dialysis showed for the first time in the present survey that diabetic nephropathy (35.7%) was more common than chronic glomerular nephritis (35.0%).
In the 1998 survey, the type and effectiveness of treatment for dialysis-related amyloidosis, type and obstruction frequency of blood access, life style, activity, transportation method to dialysis center, blood flow rate as well as the kind and flow rate of dialysate were included in the survey questionnaire for the first time.
The prevalence of dialysis-related amyloidosis was 31.0%. The mean blood flow rate of the hemodialysis patients was 189.8ml/min (±36.4 S. D.). Patients commuting to and from dialysis facilities on their own accounted for no more than 61.6% of the overall; 9.8% of patients replied they “were bedridden more than half the day or all day.” Some 82.9% of all of the patients lived at home with their families, and 6.9% lived by themselves. 9.5% of patients were hospitalized. From analysis of the survival prognosis, patients administered Vitamin D3 had a significantly low death risk. Conversely, patients for whom the product of their predialysis serum calcium and phosphorus concentration was less than 40 or over 70 shown to have a significantly high risk of death.
It was also found that many years on dialysis or a serum intact parathyroid hormone concentration of over 360pg/ml was a risk factor for parathyroidectomy.
