| 特集名 | 創造する透析医療―新たなmodalityへの期待と課題 | |
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| 題名 | 新たなmodality（2）合衆国における短時間頻回在宅血液透析の利点とその普及 | |
| 発刊年月 | 2017年 06月 | |
| 著者 | 小川 智也 | 埼玉医科大学総合医療センター腎高血圧内科・人工腎臓部 |
| 【 要旨 】 | 日本の慢性透析患者は32万人を超えたが，しかし，在宅血液透析患者の割合は1％にも満たない．在宅透析により患者の生命予後やQOLの改善が期待されている． 筆者は在宅透析を学ぶために，2012年11月から2013年2月まで米国インディアナ大学において研修した．訪問した施設では，積極的に短時間頻回血液透析が行われていた．装置は，NxStage社のNxStage System Oneのシステムが用いられていた．この装置は操作ボタンが非常に少なく，使いやすかった．また患者教育もスムースに行われていた．一方日本では施設透析の設備consoleをそのまま自宅に持ち帰り，施設に近い透析が行われている． 日本の在宅血液透析は質が高い．しかし，装置やシステムが難しいために，在宅血液透析を実際に行える患者数も少ない．今後一人でも多くの患者が在宅血液透析を行えるように，装置やシステムや教育方法を改革していく必要がある． |
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| Theme | Creation of hemodialysis modalities for new goals | |
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| Title | Advantages and prevalence of at-home short daily hemodialysis in the United States | |
| Author | Tomonari Ogawa | Department of Nephrology & Hypertension, Blood Purification, Saitama Medical Center |
| [ Summary ] | The number of chronic dialysis patients in Japan is over 320,000. However, the percentage of at-home hemodialysis (HHD) patients is less than 1 percent.HHD is expected to improve patients' prognosis and quality of life. In order to learn home hemodialysis, I studied at the department of nephrology in Indiana University in the United States from November 2012 to February 2013. Conducting short daily dialysis was the norm at the facility I visited. They were using the NxStage System One system manufactured by NxStage Medical Inc. This system had very few buttons and was easy to use. Patient education was also conducted smoothly. Meanwhile in Japan, the dialysis facility's device is taken home as is and dialysis similar to that of a facility is conducted. The quality at home hemodialysis in Japan is high. However, very few patients can do HHD because the devices and systems are difficult to use. Devices, systems, and educational methods need to be reformed so that more patients can conduct HHD. |
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