臨牀透析 Vol.13 No.6(2-1)


特集名 世界の透析事情
題名 外国の透析事情 (1) 米国・カナダ
発刊年月 1997年 06月
著者 斉藤 明 ワシントン大学(シアトル)医学部内科
【 要旨 】 米国・カナダの末期腎不全医療は本邦と著しく異なっている.もっとも顕著な相違は全末期腎不全患者に占める移植患者数の高さにあり,続いてCAPD患者数の占める比率であろう.CAPD患者比率については,カナダの35%と米国の15%の間にも違いがある.血液透析では糖尿病性腎症患者比率の高さにみられるような患者の状態の違いと,透析医療費の低廉化からくる透析量の低さとにより,両国の患者の死亡率は著しく高い.米国では,70.9%の患者に再使用透析器が用いられており,1透析器当り20回以上の再使用がなされていると思われる.相対的な透析不足傾向のためか,エリスロポエチンは90%弱の患者に1週1万単位以上が使用されている.
Theme World Wide Current Trend of Dialysis Therapy
Title Dialysis situation in foreign countries -- U.S.A. and Canada
Author Akira Saito Division of Nephrology, Department of Medicine, University of Washington School of Medicine
[ Summary ] There are big differences in the therapy of end stage renal diseases (ESRD) between in U.S.A., Canada and Japan. The most remarkable differences between them were percentages of renal transplant patients in all ESRD patients. Secondly, percentages of CAPD patients were also different, 6% in Japan, 15% in U.S.A. and 35% in Canada. Mortality rate of hemodialysis patients in U.S.A. and Canada were remarkably higher than that in Japan because of severity of patient states and shortage of dialysis doses. In U.S.A. 70.9 % of hemodialysis patients were treated with reused dialyzers, and in general one dialyzer was reused more than 20 times. In such situation, nearly 90% of hemodialysis patients were received erythropoietin (EPO) administrations, and more than 10,000 IU/week used for those patients in U.S.A.
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