Care for patients carrying out dialysis therapy at home.

The goal of home dialysis is to more successfully reintegrate dialysis patients with high activities in daily life (ADL) into society as compared to hemodialysis (HD), which is carried out at a dialysis facility. By achieving this goal, this therapy can prove to be more effective than renal plantation, which has been carried out only in a few cases in Japan. Since self-management forms the basis of home dialysis, dialysis complications can be reduced by arranging meals, fluid management and dialysis schedule according to the lifestyle of the patient himself.

Searching for the reasons for drop-out from peritoneal dialysis: a nationwide survey in Japan.

Purpose: We wanted to clarify, in a large population, the reasons that peritoneal dialysis (PD) was interrupted and to propose appropriate strategies that might prolong the use of PD as a renal replacement therapy.

Patients And Methods: We enrolled 5 391 patients from 439 centers into the study. Each center used a worksheet to report details about patients who either transferred to hemodialysis (HD) or died on continuous ambulatory peritoneal dialysis (CAPD) over a 6-month period from 1 April 2000, to 30 September 2000.

[Significance of serum calcium and phosphorus control for the cardiac function in patients with long term hemodialysis].

We evaluated how serum calcium and phosphorus will effect a cardiomegaly of hemodialysis patients. The cardiac valve of hemodialysis patients have a high incidence of calcification. Forty four percent of mitral valve and seventy five percent of aortic valve occurred the calcification, and the progress of calcification involve with increasing LVMI.

Encapsulating peritoneal sclerosis in Japan: a prospective, controlled, multicenter study.

Background: Encapsulating peritoneal sclerosis (EPS) is recognized as a rare but serious complication of peritoneal dialysis (PD). The aim of this study was to determine the incidence, clinical features, and mortality rate of EPS.

Methods: The authors requested the registration of all PD patients in facilities across Japan where more than 10 patients were treated with PD in this prospective multicenter study.

Effects of L-threo-3,4-dihydroxyphenylserine on orthostatic hypotension in hemodialysis patients.

Background: Orthostatic hypotension (OH) is a serious complication observed in hemodialysis (HD) patients after HD as well as during the interdialytic period. L-Threo-3,4-dihydroxyphenylserine (L-DOPS) is a nonphysiological neutral amino acid that is directly converted to the neurotransmitter norepinephrine by aromatic L-amino acid decarboxylase.

Methods: A placebo-controlled double-blind study for 4 consecutive weeks and a long-term study (24-52 weeks) were conducted to evaluate the efficacy of L-DOPS for OH after HD.

Clinical effects of L-threo-3,4-dihydroxyphenylserine on orthostatic hypotension in hemodialysis patients.

Orthostatic hypotension is one of the major factors interfering with everyday activities in hemodialysis patients, but there has been no effective agent for treating it. In order to clarify the clinical effects of L-threo-3,4-dihydroxyphenylserine (L-DOPS) on orthostatic hypotension of hemodialysis patients, we conducted a randomized, double-blind comparative trial. 149 regular hemodialysis patients with orthostatic hypotension were randomly allocated to three groups and L-DOPS at doses of 400 mg, 200 mg or placebo was orally administrated to each group 30 min before starting every hemodialysis for 4 weeks.