Significance of the decreased risk of dialysis-related XXXX now proven by results from Japanese nationwide surveys in 1998 and 2010.

@entity923 @entity1 @entity6393 @entity2783
BACKGROUND: Although dialysis technology greatly improved in recent years, it remained unclear whether those improvements helped decrease the incidence of dialysis-related @entity2783 (DRA). Accordingly, we retrospectively compared the incidence of first-time @entity923 ( @entity923 )-as proxy for DRA onset-in two cohorts of chronic hemodialysis @entity1 , with the second cohort studied after dialysis methods (especially dialyzate quality control) had greatly improved. METHODS: We used the 1998 and 2010 Japan Renal Data Registries to compare crude risk of first-time @entity923 the following year. After adjusting for @entity1 background and laboratory data, odds ratios (ORs) for @entity923 in the whole cohorts and the populations matched by propensity score (PS) for hemodialysis and hemodiafiltration were calculated at a 95% confidence interval. RESULTS: Of note, 2 02 726 @entity1 were analyzed. In the 1998 cohort, 1.77% experienced first-time @entity923 compared with 1.30% of the 2010 cohort (P < 0.001); with 2010 as referent, the adjusted 1998 OR was 2.22 (1.68-2.95). Both crude risks and adjusted ORs were analyzed by dialysis vintage, age, pre-dialysis @entity6393 (b2m) and b2m clearance, risk of @entity923 trending 1.5-2.0 higher in 1998 than 2010. The reduction was most prominent in @entity1 with longer dialysis vintage, @entity1 who were younger, and those with lower pre-dialysis b2m levels. Similar results were obtained by PS-matched analysis. We also found that b2m clearance >80% may reduce risk of @entity923 . CONCLUSIONS: The incidence of first-time @entity923 as proxy for DRA decreased significantly from 1998 to 2010. Several factors may have contributed to this decrease, including improved dialysis methods.
