BACKGROUND The prevalence and severity of anemia differ between diabetic and non-diabetic patients. We investigated whether the effect of hemoglobin (Hb) on patient outcome was affected by the presence or absence of diabetes among Japanese patients receiving chronic hemodialysis (HD). METHODS We enrolled 149,308 patients from a nationwide dialysis registry in Japan at the end of 2012 (mean age, 67.6 ± 12.3 years; male, 61.7%; diabetes, 43.5%; median dialysis duration, 65 months) who underwent three HD sessions weekly. One-year all-cause and cardiovascular (CV) mortality were assessed using Cox regression analysis and competing-risks regression analysis. We used multiple imputation to deal with missing covariate data. RESULTS Baseline Hb and serum ferritin levels were independently associated with all-cause and CV mortality. In non-diabetic patients, a significantly higher risk for all-cause mortality compared to the reference group (10 to 11 g/dL) was observed in patients with Hb < 8 g/dL (hazard ratio (HR): 1.266; 95% confidence interval (CI) 1.097-1.460) and 8 to 9 g/dL(HR: 1.153; 95% CI 1.030-1.290). On the other hand, diabetic HD patients in the same Hb category group did not have increased risk of all-cause mortality. CONCLUSIONS We found that non-diabetic HD patients had an increased risk of all-cause mortality if they had lower Hb levels, whereas the effect of Hb levels on mortality was attenuated in diabetic HD patients. These data suggest that the association between Hb levels and mortality rate could be different between diabetic and non-diabetic HD patients.
The Associazione Medici Diabetologi (AMD) annals initiative is an ongoing observational survey promoted by AMD. It is based on a public network of about 700 Italian diabetes clinics, run by specialists who provide diagnostic confirmation and prevention and treatment of diabetes and its complications. Over the last few years, analysis of the AMD annals dataset has contributed several important insights on the clinical features of type-2 diabetes kidney disease and their prognostic and therapeutic...
The annual survey of The Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) was conducted for 4396 dialysis facilities at the end of 2016, among which 4336 facilities (98.6%) responded. The response rate of the 2016 survey was comparable with the past, even though it was the second year after the new anonymization method. The number of chronic dialysis patients in Japan continues to increase every year; it has reached 329,609 at the end of 2016. The mean age was 68.15 years. The pr...
This article summarizes the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry's 2015 Annual Report. It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2015 within 36 countries. In 2016 and 2017, the ERA-EDTA Registry received data on patients who were undergoing RRT for ESRD in 2015, from 52 national or regional renal registries. Thirty-two registries provided individual patient-level data and 20 prov...
#2Sumei Zhao(Capital Medical University)H-Index: 1
Abstract Background No consensus exists regarding the factors influencing mortality in patients undergoing hemodialysis (HD). This meta-analysis aimed to evaluate the impact of various patient characteristics on the risk of mortality in such patients. Methods PubMed, Embase, and Cochrane Central were searched for studies evaluating the risk factors for mortality in patients undergoing HD. The factors included age, gender, diabetes mellitus (DM), body mass index (BMI), previous cardiovascular dis...
Renal anemia is a complication of chronic kidney disease. Guidelines for safe and effective treatment in patients with renal anemia are needed. The Japanese Society for Dialysis Therapy (JSDT) published guidelines for the treatment of renal anemia in chronic hemodialysis patients in 2004 and in hemodialysis, peritoneal dialysis, predialysis, and pediatric patients in 2008. These two publications provide excellent guidance with respect to clinical practice issues, including the definition and dia...
#2Yoon Jung Chae(CBNU: Chonbuk National University)H-Index: 1
Last. Won Kim(CBNU: Chonbuk National University)H-Index: 25
view all 7 authors...
: Whole blood viscosity (WBV) plays a role in hemorheology and is determined by many factors such as red blood cell factors, plasma protein and blood volume. As WBV changes during hemodialysis, mortality may be due to changes in WBV in patients on hemodialysis. However, there are few prospective data on the relationship between changes in WBV and overall mortality in dialysis patients. We tried to investigate the correlations between values of WBV at variable shear rates before and after hemodia...
Background The decision about the type and location of a hemodialysis vascular access is challenging and can be affected by multiple factors. We explored the effect of several a priori chosen patient characteristics on access outcomes. Methods We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through November 13, 2014. We included studies that evaluated patency, mortality, access infection, and maturation of vascular ...
Background and Objectives: Glycated hemoglobin (HbA1c) dosage is considered the gold standard in glycol-metabolic monitoring, but it presents limits, which can underestimate the glycemia trend. In this regard, it was introduced the glycated albumin (GA). The aim of the study is to verify the predictivity of the GA compared to HbA1c in identifying glyco-metabolic alterations in non-diabetic and diabetic hemodialysis (HD) patients. Materials and Methods: For this purpose, we conducted a multicente...
#1Yukio Maruyama(Jikei University School of Medicine)H-Index: 18
#2Takahito Niikura(Jikei University School of Medicine)H-Index: 4
Last. Takashi Yokoo(Jikei University School of Medicine)H-Index: 28
view all 5 authors...
Anemia treatment is crucial in the management of dialyzed patients. Although Hb and serum ferritin levels are commonly used as indicators for treatment, these values change over time due to changes in policy, drugs for treating anemia, and target levels suggested by clinical guidelines. To clarify long-term changes in anemia-related parameters in Japan, we extracted annual patient data from a newly developed web-based system by the Japanese Society for Dialysis Therapy, the Web-based Analysis of...
