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Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS

Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitu...

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Autores principales: Akizawa, Tadao, Pisoni, Ronald L., Akiba, Takashi, Saito, Akira, Fukuhara, Shunichi, Asano, Yasushi, Hasegawa, Takeshi, Port, Friedrich K., Kurokawa, Kiyoshi
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568010/
https://www.ncbi.nlm.nih.gov/pubmed/18577535
http://dx.doi.org/10.1093/ndt/gfn346
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author Akizawa, Tadao
Pisoni, Ronald L.
Akiba, Takashi
Saito, Akira
Fukuhara, Shunichi
Asano, Yasushi
Hasegawa, Takeshi
Port, Friedrich K.
Kurokawa, Kiyoshi
author_facet Akizawa, Tadao
Pisoni, Ronald L.
Akiba, Takashi
Saito, Akira
Fukuhara, Shunichi
Asano, Yasushi
Hasegawa, Takeshi
Port, Friedrich K.
Kurokawa, Kiyoshi
author_sort Akizawa, Tadao
collection PubMed
description Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia management practices and outcomes for Japanese HD patients. Results. From 1999 to 2006, patient mean Hb increased from 9.7 g/dl to 10.4 g/dl, and the percentage of facilities with median Hb ≥10 g/dl increased from 27% to 75%. Hb was measured in the supine position for 90% of patients, resulting in substantially lower reported Hb values than those seen in other countries. As of 2006, erythropoietin (Epo) was prescribed to 83% of HD patients; mean Epo dose was 5231 units/week; intravenous (IV) iron use was 33% and median IV iron dose was 160 mg/month. Many patient- and facility-level factors were significantly related to higher Hb. A consistent overall pattern of lower mortality risk with higher baseline Hb levels was seen (RR = 0.89 per 1 g/dl higher Hb, P = 0.003). Facilities with median Hb ≥10.4 displayed a lower mortality risk (RR = 0.77, P = 0.03) versus facility median Hb <10.4 g/dl. Lower Hb levels were not significantly related to hospitalization risk, but were associated with lower QoL scores. Conclusions. These results provide detailed information on anaemia management practices in Japan and the relationships of anaemia control with outcomes, with implications of anaemia management worldwide.
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spelling pubmed-25680102009-02-25 Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS Akizawa, Tadao Pisoni, Ronald L. Akiba, Takashi Saito, Akira Fukuhara, Shunichi Asano, Yasushi Hasegawa, Takeshi Port, Friedrich K. Kurokawa, Kiyoshi Nephrol Dial Transplant Dialysis Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia management practices and outcomes for Japanese HD patients. Results. From 1999 to 2006, patient mean Hb increased from 9.7 g/dl to 10.4 g/dl, and the percentage of facilities with median Hb ≥10 g/dl increased from 27% to 75%. Hb was measured in the supine position for 90% of patients, resulting in substantially lower reported Hb values than those seen in other countries. As of 2006, erythropoietin (Epo) was prescribed to 83% of HD patients; mean Epo dose was 5231 units/week; intravenous (IV) iron use was 33% and median IV iron dose was 160 mg/month. Many patient- and facility-level factors were significantly related to higher Hb. A consistent overall pattern of lower mortality risk with higher baseline Hb levels was seen (RR = 0.89 per 1 g/dl higher Hb, P = 0.003). Facilities with median Hb ≥10.4 displayed a lower mortality risk (RR = 0.77, P = 0.03) versus facility median Hb <10.4 g/dl. Lower Hb levels were not significantly related to hospitalization risk, but were associated with lower QoL scores. Conclusions. These results provide detailed information on anaemia management practices in Japan and the relationships of anaemia control with outcomes, with implications of anaemia management worldwide. Oxford University Press 2008-11 2008-06-24 /pmc/articles/PMC2568010/ /pubmed/18577535 http://dx.doi.org/10.1093/ndt/gfn346 Text en © The Author [2008]. http://creativecommons.org/licenses/by-nc/2.0/uk/ The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org
spellingShingle Dialysis
Akizawa, Tadao
Pisoni, Ronald L.
Akiba, Takashi
Saito, Akira
Fukuhara, Shunichi
Asano, Yasushi
Hasegawa, Takeshi
Port, Friedrich K.
Kurokawa, Kiyoshi
Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS
title Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS
title_full Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS
title_fullStr Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS
title_full_unstemmed Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS
title_short Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS
title_sort japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the dopps
topic Dialysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568010/
https://www.ncbi.nlm.nih.gov/pubmed/18577535
http://dx.doi.org/10.1093/ndt/gfn346
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