Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS
Identifieur interne : 001302 ( Istex/Corpus ); précédent : 001301; suivant : 001303Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS
Auteurs : Tadao Akizawa ; Ronald L. Pisoni ; Takashi Akiba ; Akira Saito ; Shunichi Fukuhara ; Yasushi Asano ; Takeshi Hasegawa ; Friedrich K. Port ; Kiyoshi KurokawaSource :
- Nephrology Dialysis Transplantation [ 0931-0509 ] ; 2008-11.
Abstract
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 gdl to 10.4 gdl, and the percentage of facilities with median Hb 10 gdl 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 unitsweek; intravenous (IV) iron use was 33 and median IV iron dose was 160 mgmonth. 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 gdl 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 gdl. 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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DOI: 10.1093/ndt/gfn346
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Pisoni</name><affiliation><mods:affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Akiba, Takashi" sort="Akiba, Takashi" uniqKey="Akiba T" first="Takashi" last="Akiba">Takashi Akiba</name><affiliation><mods:affiliation>Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. 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Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Fukuhara, Shunichi" sort="Fukuhara, Shunichi" uniqKey="Fukuhara S" first="Shunichi" last="Fukuhara">Shunichi Fukuhara</name><affiliation><mods:affiliation>Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Kyoto</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Asano, Yasushi" sort="Asano, Yasushi" uniqKey="Asano Y" first="Yasushi" last="Asano">Yasushi Asano</name><affiliation><mods:affiliation>Department of Internal Medicine, Jichi Medical School and Koga Red Cross Hospital, Ibaragi</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Hasegawa, Takeshi" sort="Hasegawa, Takeshi" uniqKey="Hasegawa T" first="Takeshi" last="Hasegawa">Takeshi Hasegawa</name></author><author><name sortKey="Port, Friedrich K" sort="Port, Friedrich K" uniqKey="Port F" first="Friedrich K." last="Port">Friedrich K. Port</name><affiliation><mods:affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Kurokawa, Kiyoshi" sort="Kurokawa, Kiyoshi" uniqKey="Kurokawa K" first="Kiyoshi" last="Kurokawa">Kiyoshi Kurokawa</name><affiliation><mods:affiliation>The Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:522E1D4D2C4415001BB2D38529B23661754FA6D5</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1093/ndt/gfn346</idno><idno type="url">https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001302</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS</title><author><name sortKey="Akizawa, Tadao" sort="Akizawa, Tadao" uniqKey="Akizawa T" first="Tadao" last="Akizawa">Tadao Akizawa</name><affiliation><mods:affiliation>Division of Nephrology, Showa University School of Medicine, Tokyo, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Pisoni, Ronald L" sort="Pisoni, Ronald L" uniqKey="Pisoni R" first="Ronald L." last="Pisoni">Ronald L. Pisoni</name><affiliation><mods:affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Akiba, Takashi" sort="Akiba, Takashi" uniqKey="Akiba T" first="Takashi" last="Akiba">Takashi Akiba</name><affiliation><mods:affiliation>Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Saito, Akira" sort="Saito, Akira" uniqKey="Saito A" first="Akira" last="Saito">Akira Saito</name><affiliation><mods:affiliation>Department of Internal Medicine and Institute of Medical Science, Tokai University School of Medicine, Isehara, Kanagawa</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Fukuhara, Shunichi" sort="Fukuhara, Shunichi" uniqKey="Fukuhara S" first="Shunichi" last="Fukuhara">Shunichi Fukuhara</name><affiliation><mods:affiliation>Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Kyoto</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Asano, Yasushi" sort="Asano, Yasushi" uniqKey="Asano Y" first="Yasushi" last="Asano">Yasushi Asano</name><affiliation><mods:affiliation>Department of Internal Medicine, Jichi Medical School and Koga Red Cross Hospital, Ibaragi</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Hasegawa, Takeshi" sort="Hasegawa, Takeshi" uniqKey="Hasegawa T" first="Takeshi" last="Hasegawa">Takeshi Hasegawa</name></author><author><name sortKey="Port, Friedrich K" sort="Port, Friedrich K" uniqKey="Port F" first="Friedrich K." last="Port">Friedrich K. Port</name><affiliation><mods:affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author><author><name sortKey="Kurokawa, Kiyoshi" sort="Kurokawa, Kiyoshi" uniqKey="Kurokawa K" first="Kiyoshi" last="Kurokawa">Kiyoshi Kurokawa</name><affiliation><mods:affiliation>The Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Nephrology Dialysis Transplantation</title><title level="j" type="abbrev">Nephrol Dial Transplant</title><idno type="ISSN">0931-0509</idno><idno type="eISSN">1460-2385</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2008-11">2008-11</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="3643">3643</biblScope><biblScope unit="page" to="3653">3653</biblScope></imprint><idno type="ISSN">0931-0509</idno></series><idno type="istex">522E1D4D2C4415001BB2D38529B23661754FA6D5</idno><idno type="DOI">10.1093/ndt/gfn346</idno><idno type="ArticleID">gfn346</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0931-0509</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">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 gdl to 10.4 gdl, and the percentage of facilities with median Hb 10 gdl 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 unitsweek; intravenous (IV) iron use was 33 and median IV iron dose was 160 mgmonth. 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 gdl 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 gdl. 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.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Tadao Akizawa</name><affiliations><json:string>Division of Nephrology, Showa University School of Medicine, Tokyo, Japan</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item><json:item><name>Ronald L. Pisoni</name><affiliations><json:string>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item><json:item><name>Takashi Akiba</name><affiliations><json:string>Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item><json:item><name>Akira Saito</name><affiliations><json:string>Department of Internal Medicine and Institute of Medical Science, Tokai University School of Medicine, Isehara, Kanagawa</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item><json:item><name>Shunichi Fukuhara</name><affiliations><json:string>Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Kyoto</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item><json:item><name>Yasushi Asano</name><affiliations><json:string>Department of Internal Medicine, Jichi Medical School and Koga Red Cross Hospital, Ibaragi</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item><json:item><name>Takeshi Hasegawa</name></json:item><json:item><name>Friedrich K. Port</name><affiliations><json:string>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item><json:item><name>Kiyoshi Kurokawa</name><affiliations><json:string>The Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan</json:string><json:string>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>anaemia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DOPPS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hospitalization</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>mortality</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>quality of life</value></json:item></subject><articleId><json:string>gfn346</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>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 gdl to 10.4 gdl, and the percentage of facilities with median Hb 10 gdl 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 unitsweek; intravenous (IV) iron use was 33 and median IV iron dose was 160 mgmonth. 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 gdl 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 gdl. 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.</abstract><qualityIndicators><score>8</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1694</abstractCharCount><pdfWordCount>8156</pdfWordCount><pdfCharCount>49321</pdfCharCount><pdfPageCount>11</pdfPageCount><abstractWordCount>261</abstractWordCount></qualityIndicators><title>Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS</title><genre><json:string>research-article</json:string></genre><host><volume>23</volume><publisherId><json:string>ndt</json:string></publisherId><pages><last>3653</last><first>3643</first></pages><issn><json:string>0931-0509</json:string></issn><issue>11</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1460-2385</json:string></eissn><title>Nephrology Dialysis Transplantation</title></host><categories><wos><json:string>TRANSPLANTATION</json:string><json:string>UROLOGY & NEPHROLOGY</json:string></wos></categories><publicationDate>2008</publicationDate><copyrightDate>2008</copyrightDate><doi><json:string>10.1093/ndt/gfn346</json:string></doi><id>522E1D4D2C4415001BB2D38529B23661754FA6D5</id><score>0.23362571</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>The Author [2008].</p></availability><date>2008-06-24</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS</title><author xml:id="author-1"><persName><forename type="first">Tadao</forename><surname>Akizawa</surname></persName><affiliation>Division of Nephrology, Showa University School of Medicine, Tokyo, Japan</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author><author xml:id="author-2"><persName><forename type="first">Ronald L.</forename><surname>Pisoni</surname></persName><affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author><author xml:id="author-3"><persName><forename type="first">Takashi</forename><surname>Akiba</surname></persName><affiliation>Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author><author xml:id="author-4"><persName><forename type="first">Akira</forename><surname>Saito</surname></persName><affiliation>Department of Internal Medicine and Institute of Medical Science, Tokai University School of Medicine, Isehara, Kanagawa</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author><author xml:id="author-5"><persName><forename type="first">Shunichi</forename><surname>Fukuhara</surname></persName><affiliation>Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Kyoto</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author><author xml:id="author-6"><persName><forename type="first">Yasushi</forename><surname>Asano</surname></persName><affiliation>Department of Internal Medicine, Jichi Medical School and Koga Red Cross Hospital, Ibaragi</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author><author xml:id="author-7"><persName><forename type="first">Takeshi</forename><surname>Hasegawa</surname></persName></author><author xml:id="author-8"><persName><forename type="first">Friedrich K.</forename><surname>Port</surname></persName><affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author><author xml:id="author-9"><persName><forename type="first">Kiyoshi</forename><surname>Kurokawa</surname></persName><affiliation>The Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation></author></analytic><monogr><title level="j">Nephrology Dialysis Transplantation</title><title level="j" type="abbrev">Nephrol Dial Transplant</title><idno type="pISSN">0931-0509</idno><idno type="eISSN">1460-2385</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2008-11"></date><biblScope unit="volume">23</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="3643">3643</biblScope><biblScope unit="page" to="3653">3653</biblScope></imprint></monogr><idno type="istex">522E1D4D2C4415001BB2D38529B23661754FA6D5</idno><idno type="DOI">10.1093/ndt/gfn346</idno><idno type="ArticleID">gfn346</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008-06-24</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>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 gdl to 10.4 gdl, and the percentage of facilities with median Hb 10 gdl 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 unitsweek; intravenous (IV) iron use was 33 and median IV iron dose was 160 mgmonth. 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 gdl 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 gdl. 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.</p></abstract><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>anaemia</term></item><item><term>DOPPS</term></item><item><term>hospitalization</term></item><item><term>mortality</term></item><item><term>quality of life</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-06-24">Created</change><change when="2008-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="publisher-id">ndt</journal-id><journal-id journal-id-type="hwp">ndt</journal-id><journal-title>Nephrology Dialysis Transplantation</journal-title><abbrev-journal-title abbrev-type="pubmed">Nephrol Dial Transplant</abbrev-journal-title><issn pub-type="ppub">0931-0509</issn><issn pub-type="epub">1460-2385</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/ndt/gfn346</article-id><article-id pub-id-type="publisher-id">gfn346</article-id><article-categories><subj-group subj-group-type="heading"><subject>Dialysis</subject></subj-group></article-categories><title-group><article-title>Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS</article-title><alt-title alt-title-type="left-running">T. Akizawa <italic>et al</italic>.</alt-title><alt-title alt-title-type="right-running">Anaemia and outcomes in Japanese HD patients: DOPPS</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Akizawa</surname><given-names>Tadao</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Pisoni</surname><given-names>Ronald L.</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Akiba</surname><given-names>Takashi</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Saito</surname><given-names>Akira</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Fukuhara</surname><given-names>Shunichi</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Asano</surname><given-names>Yasushi</given-names></name><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Hasegawa</surname><given-names>Takeshi</given-names></name><xref ref-type="aff" rid="af5 af7">5,7</xref></contrib><contrib contrib-type="author"><name><surname>Port</surname><given-names>Friedrich K.</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Kurokawa</surname><given-names>Kiyoshi</given-names></name><xref ref-type="aff" rid="af8">8</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Division of Nephrology</addr-line>, <institution>Showa University School of Medicine</institution>, <addr-line>Tokyo</addr-line>, <country>Japan</country></aff><aff id="af2"><label>2</label><addr-line>Arbor Research Collaborative for Health, Ann Arbor, MI</addr-line>, <country>USA</country></aff><aff id="af3"><label>3</label><addr-line>Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo</addr-line> <institution>Women's Medical University</institution>, <addr-line>Tokyo</addr-line></aff><aff id="af4"><label>4</label><addr-line>Department of Internal Medicine and Institute of Medical Science</addr-line>, <institution>Tokai University School of Medicine</institution>, <addr-line>Isehara, Kanagawa</addr-line></aff><aff id="af5"><label>5</label><addr-line>Department of Epidemiology and Healthcare Research, Graduate School of Medicine</addr-line>, <institution>Kyoto University</institution>, <addr-line>Kyoto</addr-line></aff><aff id="af6"><label>6</label><addr-line>Department of Internal Medicine, Jichi Medical School and Koga Red Cross Hospital, Ibaragi</addr-line></aff><aff id="af7"><label>7</label><addr-line>Division of Nephrology, Department of Internal Medicine</addr-line>, <institution>Showa University Fujigaoka Hospital</institution>, <addr-line>Yokohama</addr-line></aff><aff id="af8"><label>8</label><addr-line>The Research Center for Advanced Science and Technology</addr-line>, <institution>University of Tokyo</institution>, <addr-line>Tokyo</addr-line>, <country>Japan</country></aff><author-notes><corresp><italic>Correspondence and offprint requests to</italic>: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: <phone>+81-3-3784-8686</phone>; Fax: <fax>+81-3-3784-3751</fax>; E-mail: <email>akizawa@med.showa-u.ac.jp</email></corresp></author-notes><pub-date pub-type="ppub"><month>11</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>24</day><month>6</month><year>2008</year></pub-date><volume>23</volume><issue>11</issue><fpage>3643</fpage><lpage>3653</lpage><history><date date-type="received"><day>3</day><month>7</month><year>2007</year></date><date date-type="accepted"><day>26</day><month>5</month><year>2008</year></date></history><permissions><copyright-statement>© The Author [2008].</copyright-statement><copyright-year>2008</copyright-year><copyright-holder>Oxford University Press</copyright-holder><license license-type="creative-commons" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/uk/"><p>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</p></license></permissions><abstract><p><bold>Background.</bold> 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.</p><p><bold>Methods.</bold> 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.</p><p><bold>Results.</bold> 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, <italic>P</italic> = 0.003). Facilities with median Hb ≥10.4 displayed a lower mortality risk (RR = 0.77, <italic>P</italic> = 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.</p><p><bold>Conclusions.</bold> 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.</p></abstract><kwd-group><title>Keywords</title><kwd>anaemia</kwd><kwd>DOPPS</kwd><kwd>hospitalization</kwd><kwd>mortality</kwd><kwd>quality of life</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Japanese haemodialysis anaemia management practices and outcomes (19992006): results from the DOPPS</title></titleInfo><name type="personal"><namePart type="given">Tadao</namePart><namePart type="family">Akizawa</namePart><affiliation>Division of Nephrology, Showa University School of Medicine, Tokyo, Japan</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ronald L.</namePart><namePart type="family">Pisoni</namePart><affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Takashi</namePart><namePart type="family">Akiba</namePart><affiliation>Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Akira</namePart><namePart type="family">Saito</namePart><affiliation>Department of Internal Medicine and Institute of Medical Science, Tokai University School of Medicine, Isehara, Kanagawa</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shunichi</namePart><namePart type="family">Fukuhara</namePart><affiliation>Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Kyoto</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yasushi</namePart><namePart type="family">Asano</namePart><affiliation>Department of Internal Medicine, Jichi Medical School and Koga Red Cross Hospital, Ibaragi</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Takeshi</namePart><namePart type="family">Hasegawa</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Friedrich K.</namePart><namePart type="family">Port</namePart><affiliation>Arbor Research Collaborative for Health, Ann Arbor, MI, USA</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kiyoshi</namePart><namePart type="family">Kurokawa</namePart><affiliation>The Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan</affiliation><affiliation>Correspondence and offprint requests to: Tadao Akizawa, Division of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8666, Japan. Tel: 81-3-3784-8686; Fax: 81-3-3784-3751;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2008-11</dateIssued><dateCreated encoding="w3cdtf">2008-06-24</dateCreated><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>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 gdl to 10.4 gdl, and the percentage of facilities with median Hb 10 gdl 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 unitsweek; intravenous (IV) iron use was 33 and median IV iron dose was 160 mgmonth. 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 gdl 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 gdl. 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.</abstract><subject><genre>Keywords</genre><topic>anaemia</topic><topic>DOPPS</topic><topic>hospitalization</topic><topic>mortality</topic><topic>quality of life</topic></subject><relatedItem type="host"><titleInfo><title>Nephrology Dialysis Transplantation</title></titleInfo><titleInfo type="abbreviated"><title>Nephrol Dial Transplant</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0931-0509</identifier><identifier type="eISSN">1460-2385</identifier><identifier type="PublisherID">ndt</identifier><identifier type="PublisherID-hwp">ndt</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>3643</start><end>3653</end></extent></part></relatedItem><identifier type="istex">522E1D4D2C4415001BB2D38529B23661754FA6D5</identifier><identifier type="DOI">10.1093/ndt/gfn346</identifier><identifier type="ArticleID">gfn346</identifier><accessCondition type="use and reproduction" contentType="copyright">The Author [2008].</accessCondition><recordInfo><recordContentSource>OUP</recordContentSource><recordOrigin>Oxford University Press</recordOrigin></recordInfo></mods></metadata><covers><json:item><original>true</original><mimetype>image/tiff</mimetype><extension>tiff</extension><uri>https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/covers/tiff</uri></json:item></covers><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/annexes/jpeg</uri></json:item><json:item><original>true</original><mimetype>image/gif</mimetype><extension>gif</extension><uri>https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/annexes/gif</uri></json:item><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/annexes/pdf</uri></json:item></annexes><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/522E1D4D2C4415001BB2D38529B23661754FA6D5/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">TRANSPLANTATION</classCode><classCode scheme="WOS">UROLOGY & NEPHROLOGY</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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