The annual statistical survey conducted at the end of 2000 by the Japanese Society for Dialysis Therapy collected responses from 3, 358 (99.94%) of 3, 360 institutions. Japan's total dialysis patient population at the end of the year 2000, as identified by this survey, was 206, 134, an increase of 8, 921 (4.5%) over 1999. This translates to 1, 624.1 patients per million population. The annual crude mortality rate was 9.4% for the period starting at the end of the year 1999 and ending at the end of the year 2000. The mean patient age at the initiation of dialysis treatment was 63.8 (±13.9; ±S. D.) years; the mean age of the overall dialysis patient population was 61.2 years (±13.3). Both these mean ages, which had been increasing since 1983, again continued to increase. Among the primary diagnosis, the prevalence of diabetic nephropathy had continued to increase again since 1999, to 36.6%, whereas that of chronic glomerulonephritis had continued to decline, down to 32.5%, during the same one-year period since the 1999 survey.
The 2000 year-end survey incorporated the following additional variables for the first time: usage of oral anti-hypertensives, pre- and post- dialysis systolic and diastolic blood pressures, serum HDL cholesterol level, types and dosage of oral Vitamin D analogues administered, dosage of oral calcium carbonate administered, history of intervention for peripheral vascular disease (bypass surgery, synthetic graft replacement, stenting), history of coronary artery bypass grafting (CABG), history of percutaneous transluminal coronary angioplasty (PTCA), whether stenting had been previously performed for the treatment of ischemic heart disease, number of cigarettes smoked, the type of vascular access used at the initiation of dialysis, and the year and month the vascular access was created.
The survey results indicate that 60.9% of the total dialysis patient population was using oral antihypertensives. The patients' mean serum HDL cholesterol level was 47.65±18.47mg/dL, showing positive correlation with serum albumin level and reverse correlation with body mass index.

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BACKGROUND/AIM: We measured serum level of pentosidine in 39 dialysis patients, whose atherosclerotic change was evaluated by means of aortic calcification index (ACI) and tried to confirm a significant correlation between them.
METHOD: Thirty-nine dialysis patients (22 men, 17 wemen) aged 20-79 years (52.4±10.8 years) were studie. The mean duration of HD was 141.8±52.4 months. ACI was assessed using abdominal CT scans obtained from 1993 to 1997, and the annual change (ΔACI) was calculated. Determination of pentosidine was performed by a competitive ELISA method.
RESULTS: ACI was increased progressively and significantly as follows: 21.1±18.7 in 1993, 32.4±21.2 in 1995, and 38.4±21.8 in 1997 (p<0.0001). ΔACI (1993-1997) was 4.0±2.16 on average. Serum concentration of pentosidine was remarkably increased to as high as 2425±1161pmol/mL on average. Serum value of pentosidine/mgTP correlated weakly, but significantly with ACI (ρ=0.353 p=0.0297), but not ΔACI in univariable analysis. Multiple regression analysis showed that pentosidine/mg total protein (TP) together with calender age were significant explanatory variables for ACI.
CONCLUSION: Pentosidine is probably involved in some process common to an ubiquitous mechanism of maturation in atherosclerosis.

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The hyperparathyroid bone continues to be a major problem in dialysis treatment. A pharmacological parathyroidectomy by 22-oxacalcitriol (OCT), a new vitamin D derivative, is anticipated to be a new and alternative therapeutic modality to conventional oral vitamin D₃ pulse therapy.
To ensure the clinical viability of this new treatment, we studied the long-term effects of OCT on immunocytes in 7 hemodialysis patients as immunocometence has been acknowledged to be an important factor in survivorship. Counts of CD3, CD4, CD8, CD16, CD20, and CD25 immunocytes were obtained every 6 months over 12 months of treatment.
At the start of OCT treatment, counts of CD25 cells were as high as 76±38 /μL, but then decreased to 33±17 /μL at the termination of OCT treatment (p<0.02). The helper/suppressor cell ratio (CD4/CD8) varied within the normal range as follows; 13±0.4, 1.5±0.4 and 1.4±0.3, at the start, 6 months, and 12 months, respectively. No abnormal counts or significant variations could be found in any other immunocytes at any point in the measurement period.
We conclude, as a consequence, that the clinical application of OCT is quite safe as far as the maximum dose of 20.0μg used in the present study.

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