[Comparison of benefits to non-dialysis CKD patients between darbepoetin alpha and epoetin beta pegol].

Background: Erythropoiesis-stimulating agents (ESAs) are the mainstay of treatment for renal anemia in chronic kidney disease (CKD) patients. However, the difference in hematopoietic effect between darbepoetin alfa (DA) and continuous erythropoiesis receptor activator (CERA) has remained unclear in non-dialysis CKD patients. Another purpose of this study was to analyze the red blood cells indices under treatment with these two ESAs in ESA-naïve CKD patients.

Association between Serum Soluble Klotho Levels and Mortality in Chronic Hemodialysis Patients.

Klotho is a single-pass transmembrane protein predominantly expressed in the kidney. The extracellular domain of Klotho is subject to ectodomain shedding and is released into the circulation as a soluble form. Soluble Klotho is also generated from alternative splicing of the Klotho gene.

Prevalence of Fabry disease in dialysis patients: Japan Fabry disease screening study (J-FAST).

Background: In Fabry disease, progressive glycolipid accumulation leads to damage in kidney and other organs. This study was designed to determine the prevalence rate of Fabry disease in Japanese dialysis patients.

Methods: All dialysis patients agreeing to Japan Fabry disease screening study (J-FAST) with informed consent were selected except for Fabry disease.

Effect of chitosan chewing gum on reducing serum phosphorus in hemodialysis patients: a multi-center, randomized, double-blind, placebo-controlled trial.

Background: HS219 (40 mg chitosan-loaded chewing gum) is designed to bind salivary phosphorus as an add-on to available phosphorus binders. We performed a randomized, placebo-controlled, double-blind study to evaluate the efficacy and safety of HS219 in hemodialysis (HD) patients with hyperphosphatemia as an add-on to phosphorus binders.

Methods: Sixty-eight HD patients who were maintained on calcium carbonate (n=33) or sevelamer hydrochloride (n=35) were enrolled.

Spontaneous spinal epidural hematoma as a potentially important stroke mimic.

Hemiparesis develops in response to a wide range of neurological disorders, such as stroke, neoplasms and several inflammatory processes. Occasionally, it may also occur due to a lesion located in the high cervical spinal cord. In this concise review, we describe the features of spontaneous spinal epidural hematoma, which should be included in the large list of stroke mimics.

Fabry disease: experience of screening dialysis patients for Fabry disease.

The prevalence rate for Fabry disease is conventionally considered to be 1 case in 40,000; however, due to increased screening accuracy, reports now suggest that prevalence is 1 case in 1,500 among male children, and it is likely that the clinical importance of the condition will increase in the future. In dialysis patients to date, prevalence rates are between 0.16 and 1.

The origin of idiopathic renal arteriovenous malformation with giant twin aneurysms.

A 50-year-old female patient who presented with intermittent gross hematuria was referred to our hospital. Three-dimensional computed tomography (3D-CT) revealed a left renal arteriovenous malformation (AVM). Because she declined to undergo additional therapy including surgical treatment, we observed the clinical course of renal AVM for 7 years using 3DCT.

Effect of continuous positive airway pressure on proteinuria in obstructive sleep apnea.

Obstructive sleep apnea (OSA) is common in patients with renal disease, and an association between OSA and proteinuria has been proposed. However, the effect on proteinuria of OSA treatment with continuous positive airway pressure (CPAP) is unknown. We experienced a case of severe OSA, where proteinuria was clearly improved after CPAP initiation without any changes of medication or body weight.

Sleep-disordered breathing predicts cardiovascular events and mortality in hemodialysis patients.

Background: Sleep-disordered breathing (SDB), characterized by repetitive apnea and hypopnea during sleep, is a risk factor for cardiovascular disease. However, the links between SDB and cardiovascular events in hemodialysis (HD) patients have not been clearly evaluated.

Methods: We followed the clinical outcome of 94 HD patients, who underwent overnight pulse oximetry on dialysis day.

Cost-effectiveness of administering oral adsorbent AST-120 to patients with diabetes and advance-stage chronic kidney disease.

Aims: AST-120, an oral adsorbent currently on-label only in Asian countries with phase III trials ongoing in the US, slows renal disease progression in patients with diabetes and advanced-stage chronic kidney disease (CKD). The objective of this study is to evaluate the cost-effectiveness of using AST-120 to treat patients with type 2 diabetes and advanced-stage CKD.

Methods: We used Markov model simulating the progression of diabetic nephropathy.

Independent and joint associations of nutritional status indicators with mortality risk among chronic hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Objective: To consider the Kidney Disease Outcomes Quality Initiative recommendation of using multiple nutritional measurements for patients on maintenance dialysis, we explored data for independent and joint associations of nutritional indicators with mortality risk among maintenance hemodialysis patients treated in 12 countries.

Setting: Dialysis units in seven European countries, the United States, Canada, Australia, New Zealand, and Japan.

Main Outcome: Mortality risk.

Impact of early referral to nephrologist on mental health among hemodialysis patients: a Dialysis Outcomes and Practice Patterns Study (DOPPS).

Background: Pre-dialysis early referral is associated with improved survival in patients on dialysis. Here, we examined the association between pre-dialysis early referral and post-dialysis Mental Health (MH) in hemodialysis patients.

Methods: We examined data from the Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective and observational study of hemodialysis patients, by performing a cross-sectional and longitudinal analysis of DOPPS data from Japan.

Beta-blocker prescription and outcomes in hemodialysis patients from the Japan Dialysis Outcomes and Practice Patterns Study.

Background/aims: Given the clear benefits of mortality reduction observed for most beta-blockers in clinical trials, they are relatively underused in hemodialysis patients. Since the outcomes associated with the use of beta-blockers are not fully known, we investigated their effect on mortality among a cohort of hemodialysis patients.

Methods: Data were analyzed from the Dialysis Outcomes and Practice Patterns Study phase II for 2,286 randomly selected patients on hemodialysis in Japan.

Effect of a carbonaceous oral adsorbent on the progression of CKD: a multicenter, randomized, controlled trial.

Background: The carbonaceous oral adsorbent AST-120 slows the deterioration of kidney function in patients with advanced chronic kidney disease (CKD). However, information about AST-120 in patients with less severe stages of CKD is lacking.

Study Design: Randomized controlled trial.

Physicians make different decisions from nephrologists at serum creatinine 2.0 mg/dl.

Background: It is very important, but not clear, how physicians differ from nephrologists in treatment of renal insufficiency.

Aim: To demonstrate differences in decision-making in treatment of renal insufficiency between physicians and nephrologists.

Design Of Study: Postal questionnaire.

Biocompatibility and permeability of dialyzer membranes do not affect anemia, erythropoietin dosage or mortality in japanese patients on chronic non-reuse hemodialysis: a prospective cohort study from the J-DOPPS II study.

Background: Considerable controversy exists over the impact of the biocompatibility and flux characteristics of dialyzer membranes on anemia in chronic hemodialysis patients.

Methods: A subset of 1,207 subjects from the Japanese arm of DOPPS phase II was analyzed.

Results: Patient characteristics included mean age 59 years, male sex 60%, BMI 20.

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: 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.

Aspirin prescription and outcomes in hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Background: We investigated aspirin-prescribing patterns and potential benefits on cardiovascular morbidity and mortality in hemodialysis patients.

Study Design: Cohort study.

Setting & Participants: Data included 28,320 randomly selected hemodialysis patients from the Dialysis Outcomes and Practice Patterns Study I and II.