Integrated therapies including erythropoietin decrease the incidence of dialysis: lessons from mapping the incidence of end-stage renal disease in Japan.
Identifieur interne : 000219 ( Main/Exploration ); précédent : 000218; suivant : 000220Integrated therapies including erythropoietin decrease the incidence of dialysis: lessons from mapping the incidence of end-stage renal disease in Japan.
Auteurs : Yoshiyuki Furumatsu [Japon] ; Yasuyuki Nagasawa ; Takayuki Hamano ; Hirotsugu Iwatani ; Kenichiro Iio ; Tatsuya Shoji ; Takahito Ito ; Yoshiharu Tsubakihara ; Enyu ImaiSource :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [ 1460-2385 ] ; 2008.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Analyse de régression (MeSH), Antihypertenseurs (usage thérapeutique), Association thérapeutique (MeSH), Dialyse rénale (MeSH), Défaillance rénale chronique (thérapie), Défaillance rénale chronique (épidémiologie), Femelle (MeSH), Humains (MeSH), Incidence (MeSH), Inhibiteurs de l'enzyme de conversion de l'angiotensine (usage thérapeutique), Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (usage thérapeutique), Japon (épidémiologie), Mâle (MeSH), Érythropoïétine (usage thérapeutique), Études rétrospectives (MeSH).
- MESH :
- thérapie : Défaillance rénale chronique.
- usage thérapeutique : Antihypertenseurs, Inhibiteurs de l'enzyme de conversion de l'angiotensine, Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase, Érythropoïétine.
- épidémiologie : Défaillance rénale chronique, Japon.
- Adulte, Adulte d'âge moyen, Analyse de régression, Association thérapeutique, Dialyse rénale, Femelle, Humains, Incidence, Mâle, Études rétrospectives.
- Wicri :
- geographic : Japon.
English descriptors
- KwdEn :
- Adult (MeSH), Angiotensin-Converting Enzyme Inhibitors (therapeutic use), Antihypertensive Agents (therapeutic use), Combined Modality Therapy (MeSH), Erythropoietin (therapeutic use), Female (MeSH), Humans (MeSH), Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use), Incidence (MeSH), Japan (epidemiology), Kidney Failure, Chronic (epidemiology), Kidney Failure, Chronic (therapy), Male (MeSH), Middle Aged (MeSH), Regression Analysis (MeSH), Renal Dialysis (MeSH), Retrospective Studies (MeSH).
- MESH :
- chemical , therapeutic use : Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Erythropoietin, Hydroxymethylglutaryl-CoA Reductase Inhibitors.
- geographic , epidemiology : Japan.
- epidemiology : Kidney Failure, Chronic.
- therapy : Kidney Failure, Chronic.
- Adult, Combined Modality Therapy, Female, Humans, Incidence, Male, Middle Aged, Regression Analysis, Renal Dialysis, Retrospective Studies.
Abstract
BACKGROUND
Erythropoietin (EPO) has been reported to slow the decline of renal function in predialysis chronic kidney disease (CKD) patients. On the contrary, in the recent large-scale randomized controlled trial (RCT), CREATE and CHOIR, which aimed to keep a higher haemoglobin (Hb) level than former trials, the renoprotective effect of EPO was not observed. Today, the renoprotective effect of EPO has become controversial. In order to test the hypothesis that the usage of EPO in predialysis CKD patients may ameliorate the progression of renal disease, we conducted a macro-level observational study dealing with all Japanese predialysis CKD patients.
METHODS
Annually since 1982, the Japanese Society for Dialysis Therapy reports the number of patients that have entered maintenance dialysis in each prefecture of Japan. Based on the 2002-2004 data, we calculated the annual incidence of end-stage renal disease (ESRD) in each of the 47 prefectures. The annual amounts paid for EPO by each prefecture, presumably corresponding to the amounts used, corrected for the estimated predialysis CKD patients, were calculated. We examined the relationship between the incidence of new dialysis and the usage of EPO in each prefecture. Furthermore, the usage of EPO was compared with that of antihypertensive agents including angiotensin converting enzyme inhibitor (ACE-I), and that of statin.
RESULTS
There were prefectural differences in the annual incidence of ESRD from 2002 to 2004. We also found prefectural differences in the usage of EPO for the three consecutive years. The usage of EPO in predialysis patients was negatively correlated with the incidence of ESRD on linear and multiple regression analyses. At the same time, the usage of EPO had strong positive correlations with the usage of antihypertensive agents including ACE-I and with that of statin.
CONCLUSION
Our nationwide epidemiologic study revealed that a higher use of EPO was associated with a decreased incidence of new dialysis in daily clinical practice. In addition, there were strong correlations among the usage of EPO, antihypertensive agents and statin. These data are supportive of, but do not prove, the hypothesis that EPO may be renoprotective, when used in combination with other strategies.
DOI: 10.1093/ndt/gfm705
PubMed: 17956890
Affiliations:
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European Renal Association</title><idno type="eISSN">1460-2385</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Angiotensin-Converting Enzyme Inhibitors (therapeutic use)</term><term>Antihypertensive Agents (therapeutic use)</term><term>Combined Modality Therapy (MeSH)</term><term>Erythropoietin (therapeutic use)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)</term><term>Incidence (MeSH)</term><term>Japan (epidemiology)</term><term>Kidney Failure, Chronic (epidemiology)</term><term>Kidney Failure, Chronic (therapy)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Regression Analysis (MeSH)</term><term>Renal Dialysis (MeSH)</term><term>Retrospective Studies (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Analyse de régression (MeSH)</term><term>Antihypertenseurs (usage thérapeutique)</term><term>Association thérapeutique (MeSH)</term><term>Dialyse rénale (MeSH)</term><term>Défaillance rénale chronique (thérapie)</term><term>Défaillance rénale chronique (épidémiologie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Incidence (MeSH)</term><term>Inhibiteurs de l'enzyme de conversion de l'angiotensine (usage thérapeutique)</term><term>Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (usage thérapeutique)</term><term>Japon (épidémiologie)</term><term>Mâle (MeSH)</term><term>Érythropoïétine (usage thérapeutique)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Angiotensin-Converting Enzyme Inhibitors</term><term>Antihypertensive Agents</term><term>Erythropoietin</term><term>Hydroxymethylglutaryl-CoA Reductase Inhibitors</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Japan</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Kidney Failure, Chronic</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Kidney Failure, Chronic</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Défaillance rénale chronique</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antihypertenseurs</term><term>Inhibiteurs de l'enzyme de conversion de l'angiotensine</term><term>Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase</term><term>Érythropoïétine</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Défaillance rénale chronique</term><term>Japon</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Combined Modality Therapy</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Regression Analysis</term><term>Renal Dialysis</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de régression</term><term>Association thérapeutique</term><term>Dialyse rénale</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Japon</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Erythropoietin (EPO) has been reported to slow the decline of renal function in predialysis chronic kidney disease (CKD) patients. On the contrary, in the recent large-scale randomized controlled trial (RCT), CREATE and CHOIR, which aimed to keep a higher haemoglobin (Hb) level than former trials, the renoprotective effect of EPO was not observed. Today, the renoprotective effect of EPO has become controversial. In order to test the hypothesis that the usage of EPO in predialysis CKD patients may ameliorate the progression of renal disease, we conducted a macro-level observational study dealing with all Japanese predialysis CKD patients.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Annually since 1982, the Japanese Society for Dialysis Therapy reports the number of patients that have entered maintenance dialysis in each prefecture of Japan. Based on the 2002-2004 data, we calculated the annual incidence of end-stage renal disease (ESRD) in each of the 47 prefectures. The annual amounts paid for EPO by each prefecture, presumably corresponding to the amounts used, corrected for the estimated predialysis CKD patients, were calculated. We examined the relationship between the incidence of new dialysis and the usage of EPO in each prefecture. Furthermore, the usage of EPO was compared with that of antihypertensive agents including angiotensin converting enzyme inhibitor (ACE-I), and that of statin.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>There were prefectural differences in the annual incidence of ESRD from 2002 to 2004. We also found prefectural differences in the usage of EPO for the three consecutive years. The usage of EPO in predialysis patients was negatively correlated with the incidence of ESRD on linear and multiple regression analyses. At the same time, the usage of EPO had strong positive correlations with the usage of antihypertensive agents including ACE-I and with that of statin.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Our nationwide epidemiologic study revealed that a higher use of EPO was associated with a decreased incidence of new dialysis in daily clinical practice. In addition, there were strong correlations among the usage of EPO, antihypertensive agents and statin. These data are supportive of, but do not prove, the hypothesis that EPO may be renoprotective, when used in combination with other strategies.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">17956890</PMID><DateCompleted><Year>2008</Year><Month>04</Month><Day>23</Day></DateCompleted><DateRevised><Year>2008</Year><Month>02</Month><Day>26</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1460-2385</ISSN><JournalIssue CitedMedium="Internet"><Volume>23</Volume><Issue>3</Issue><PubDate><Year>2008</Year><Month>Mar</Month></PubDate></JournalIssue><Title>Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association</Title></Journal><ArticleTitle>Integrated therapies including erythropoietin decrease the incidence of dialysis: lessons from mapping the incidence of end-stage renal disease in Japan.</ArticleTitle><Pagination><MedlinePgn>984-90</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Erythropoietin (EPO) has been reported to slow the decline of renal function in predialysis chronic kidney disease (CKD) patients. On the contrary, in the recent large-scale randomized controlled trial (RCT), CREATE and CHOIR, which aimed to keep a higher haemoglobin (Hb) level than former trials, the renoprotective effect of EPO was not observed. Today, the renoprotective effect of EPO has become controversial. In order to test the hypothesis that the usage of EPO in predialysis CKD patients may ameliorate the progression of renal disease, we conducted a macro-level observational study dealing with all Japanese predialysis CKD patients.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Annually since 1982, the Japanese Society for Dialysis Therapy reports the number of patients that have entered maintenance dialysis in each prefecture of Japan. Based on the 2002-2004 data, we calculated the annual incidence of end-stage renal disease (ESRD) in each of the 47 prefectures. The annual amounts paid for EPO by each prefecture, presumably corresponding to the amounts used, corrected for the estimated predialysis CKD patients, were calculated. We examined the relationship between the incidence of new dialysis and the usage of EPO in each prefecture. Furthermore, the usage of EPO was compared with that of antihypertensive agents including angiotensin converting enzyme inhibitor (ACE-I), and that of statin.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">There were prefectural differences in the annual incidence of ESRD from 2002 to 2004. We also found prefectural differences in the usage of EPO for the three consecutive years. The usage of EPO in predialysis patients was negatively correlated with the incidence of ESRD on linear and multiple regression analyses. At the same time, the usage of EPO had strong positive correlations with the usage of antihypertensive agents including ACE-I and with that of statin.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Our nationwide epidemiologic study revealed that a higher use of EPO was associated with a decreased incidence of new dialysis in daily clinical practice. In addition, there were strong correlations among the usage of EPO, antihypertensive agents and statin. These data are supportive of, but do not prove, the hypothesis that EPO may be renoprotective, when used in combination with other strategies.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Furumatsu</LastName><ForeName>Yoshiyuki</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka (A8), Suita-city, Osaka 565-0871, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nagasawa</LastName><ForeName>Yasuyuki</ForeName><Initials>Y</Initials></Author><Author ValidYN="Y"><LastName>Hamano</LastName><ForeName>Takayuki</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Iwatani</LastName><ForeName>Hirotsugu</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Iio</LastName><ForeName>Kenichiro</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Shoji</LastName><ForeName>Tatsuya</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Ito</LastName><ForeName>Takahito</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Tsubakihara</LastName><ForeName>Yoshiharu</ForeName><Initials>Y</Initials></Author><Author ValidYN="Y"><LastName>Imai</LastName><ForeName>Enyu</ForeName><Initials>E</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2007</Year><Month>10</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Nephrol Dial Transplant</MedlineTA><NlmUniqueID>8706402</NlmUniqueID><ISSNLinking>0931-0509</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000806">Angiotensin-Converting Enzyme Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000959">Antihypertensive Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019161">Hydroxymethylglutaryl-CoA Reductase Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>11096-26-7</RegistryNumber><NameOfSubstance UI="D004921">Erythropoietin</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000806" MajorTopicYN="N">Angiotensin-Converting Enzyme Inhibitors</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000959" MajorTopicYN="N">Antihypertensive Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003131" MajorTopicYN="N">Combined Modality Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004921" MajorTopicYN="N">Erythropoietin</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019161" MajorTopicYN="N">Hydroxymethylglutaryl-CoA Reductase Inhibitors</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007564" MajorTopicYN="N" Type="Geographic">Japan</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007676" MajorTopicYN="N">Kidney Failure, Chronic</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012044" MajorTopicYN="N">Regression Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006435" MajorTopicYN="Y">Renal Dialysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2007</Year><Month>10</Month><Day>25</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2008</Year><Month>4</Month><Day>24</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2007</Year><Month>10</Month><Day>25</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">17956890</ArticleId><ArticleId IdType="pii">gfm705</ArticleId><ArticleId IdType="doi">10.1093/ndt/gfm705</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Japon</li></country></list><tree><noCountry><name sortKey="Hamano, Takayuki" sort="Hamano, Takayuki" uniqKey="Hamano T" first="Takayuki" last="Hamano">Takayuki Hamano</name><name sortKey="Iio, Kenichiro" sort="Iio, Kenichiro" uniqKey="Iio K" first="Kenichiro" last="Iio">Kenichiro Iio</name><name sortKey="Imai, Enyu" sort="Imai, Enyu" uniqKey="Imai E" first="Enyu" last="Imai">Enyu Imai</name><name sortKey="Ito, Takahito" sort="Ito, Takahito" uniqKey="Ito T" first="Takahito" last="Ito">Takahito Ito</name><name sortKey="Iwatani, Hirotsugu" sort="Iwatani, Hirotsugu" uniqKey="Iwatani H" first="Hirotsugu" last="Iwatani">Hirotsugu Iwatani</name><name sortKey="Nagasawa, Yasuyuki" sort="Nagasawa, Yasuyuki" uniqKey="Nagasawa Y" first="Yasuyuki" last="Nagasawa">Yasuyuki Nagasawa</name><name sortKey="Shoji, Tatsuya" sort="Shoji, Tatsuya" uniqKey="Shoji T" first="Tatsuya" last="Shoji">Tatsuya Shoji</name><name sortKey="Tsubakihara, Yoshiharu" sort="Tsubakihara, Yoshiharu" uniqKey="Tsubakihara Y" first="Yoshiharu" last="Tsubakihara">Yoshiharu Tsubakihara</name></noCountry><country name="Japon"><noRegion><name sortKey="Furumatsu, Yoshiyuki" sort="Furumatsu, Yoshiyuki" uniqKey="Furumatsu Y" first="Yoshiyuki" last="Furumatsu">Yoshiyuki Furumatsu</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document 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