| Theme | Considering the timing of chronic dialysis (renal replacement therapy) initiation | |
|---|---|---|
| Title | Circumstances concerning creation of 1992 Ministry of Welfare standards | |
| Publish Date | 2012/12 | |
| Author | Noritomo Itami | Nikko Memorial Hospital, Kidney Center |
| Author | Yoshindo Kawaguchi | Kanagawa Prefectural Shiomidai Hospital / Division of Nephrology and Hypertension, The Jikei University School of Medicine |
| [ Summary ] | The 1992 Dialysis Initiation Standards were proposed to score kidney function, clinical condition and lifestyle limitations. If the score was 60 points or more, the initiation of dialysis was deemed appropriate. The maximum score allowed for kidney function was 30 points, thus the proposal placed an emphasis on the patient's clinical condition and lifestyle limitations. The average estimated glomerular filtration rate of patients starting dialysis in Japan was approximately 5 mL/min, lower than the kidney function dialysis initiation recommendations established by European or American guidelines. It became clear, through a survey of Japanese statistics, that patients starting dialysis with a higher level of kidney function had worse prognoses. Considering these results are influenced by the 1992 Dialysis Initiation Standards, we investigated the circumstances and process of the standard's creation. | |