| 特集名 | 腹膜透析療法―ポストガイドラインの方向性 | |
|---|---|---|
| 題名 | 腹膜透析の実態調査 -- 統計調査からみた在宅透析 | |
| 発刊年月 | 2012年 05月 | |
| 著者 | 中元 秀友 | 埼玉医科大学総合診療内科 |
| 【 要旨 】 | 2009年に腹膜透析（PD）ガイドラインが世に出て，すでに3年が経過している．このガイドラインが世に示されたことで本邦のPDの状況は変わったのであろうか？ そしてこの数年間で今後のガイドライン策定のために，新たなエビデンスが示されたのであろうか．このことを明確にするためにはPDの正確な現状調査，さらに本邦独自の大規模臨床研究が必要であり，そのことは以前から認識されていた．このような環境下，日本透析医学会（JSDT）秋澤理事長の強い意志によって2009年度よりPD患者の全国調査PDレジストリをスタートした． その結果，PDの実態は以前よりも正確に把握できるようになっている．今後，PD患者の正確な生存率ならびに継続率，さらに残存腎機能の維持率も明らかにされるものと考えられる．今後のPDレジストリの成績は，本邦のPDの行方を左右する重要な統計調査といえる．今後のPDレジストリの成績に注目していきたい． |
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| Theme | Trend in Peritoneal Dialysis Therapy After Implementation of Japanese Society for Dialysis Therapy (JSDT) Peritoneal Dialysis Guideline | |
|---|---|---|
| Title | PD registry in Japan | |
| Author | Hidetomo Nakamoto | Department of General Internal Medicine, Saitama Medical University |
| [ Summary ] | In recent years, important advances have been made in the treatment of patients with end-stage renal disease (ESRD). Patients with ESRD and their physicians must consider many factors, including age, sex, jobs, quality and length of life, when choosing a treatment regimen. Because of a limited number of donor organs, most patients must undergo dialysis. The distribution of patients with ESRD in the transplantation, hemodialysis (HD) and peritoneal dialysis (PD) therapy population differs dramatically in Japan and other countries. In 2009, a nationwide statistical survey of PD patients in Japan (PD Registry) was started. The aims of the PD registry were first, to investigate trends associated with PD patients in Japan, and secondly, to establish evidence concerning Japanese PD patients. According to the PD registry, in 2009 the total number of dialysis patients in Japan at the end of that year was 290,661, as determined from the facility survey. The number of dialysis patients in Japan at the end of 2008 was 283,421, an increase of 7,240 patients (2.6 %) from the end of 2008. In contrast, according to the facility survey, the number of PD patients was 9858 at the end of 2009, an increase of 558 patients from the 2008 survey (9300 PD patients). The number of non-PD+ catheterized patients was 437. The number of new patients who were began PD in 2009 but were introduced to other therapies in the same year was 196. The total number of these PD-therapy-related patients was 633. These 633 patients were not classified as PD patients in the previous surveys. The sum of these 633 patients and the above mentioned PD patients (i.e. the total number of PD-therapy-related patients) was 10,491. The number of PD patients increased by approximately 500 because in the 2009 survey, non-member facilities that treated only PD patients were included, although they were not included in previous surveys. However, the number of PD patients is very small compared to those in other countries. Within a few years, we will be able to demonstrate data, including survival rates, technical survival rates, incidence of peritonitis, and incidence of EPS in Japanese PD patients. We must renew PD guidelines in relation to data from the PD registry. The PD registry plays an important role in gathering evidence concerning Japaneses PD patients. |
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