Results of the international DOPPS hemodialysis study in Japan

key words:血 液透析,死 亡率,罹 患率,生 活の質, DOPPS <要旨> Dialysis Outcomes and Practice Pattern Study (DOPPS)は 慢性血液透析患者の診療内容 とその治療結果に関 する国際的観察研究である.各 国の代表的な透析施設か ら無作為に抽出 した血液透析患者の透析に関する診療内容 と死亡率,罹 患率, QOLな どの治療結果 を調査 し,そ の関連を検討 した.日 本の透析患者は,他 の6か 国 と比較 し て顕著 に死亡率が低 く,透 析量の少ない患者群においては,血 流量を増加する,膜 面積 を増加する,透 析時間を延 長するなどの治療法の変更を行えば,そ の成績はさらに改善することが期待できることが明らかになった.一 方, 日本の血液透析患者のHtは,他 の6か 国と比べて著明に低 く,エ リスロポエチン投与量を増加するか,赤 芽球癆の 問題が解消 したら,投 与経路を皮下注に変更すれば改善することが示 された. 以上から,日本の血液透析患者の診療内容 をDOPPSデ ータを使 って他の6か 国 と比較することによって,透 析医 療の内容を改善できることが示された.

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