Japanese society for dialysis therapy renal data registry-a window through which we can view the details of Japanese dialysis population

Abstract

The Japanese Society for Dialysis Therapy (JSDT) collects the clinical data from all the facilities to create a nation-wide registry system named JSDT Renal Data Registry (JRDR). This survey was begun in 1966 as a form of facility survey. Patient survey started in 1983. More than 95% of facilities respond to the survey on the basis of voluntary work of facility staffs. Therefore, JRDR has the longest history and the most comprehensive coverage. As for the prevalent patients, 304,856 patients are treated by dialysis therapy in Japan as of the year 2011. The demographics of the Japanese dialysis population have been markedly changing in terms of age, primary diagnoses and dialysis vintage. The mean age of prevalent population reaches 66.55 years at the end of 2011. The increase in the numbers of dialysis population is due to the growth of those older than 65 years old. Patients with the vintage longer than 20 years account for 8% of the entire population. Around 38 thousands patients started their dialysis treatments, whereas 31 thousands deceased. The disease burden of cardiovascular diseases as well as infection is substantial due to the demographic changes. Many evidences have been reported from the data obtained from JRDR to date. These findings covers a wide range of dialysis practice and are utilized for the development of JSDT guidelines. Therefore, JRDR has provided indispensable and fundamental data of Japanese dialysis population.

Keywords: The Japanese Society for Dialysis Therapy Renal Data Registry (JRDR); aging population; demographics.

Figure 1

Trend of response rate and facility numbers. Facility numbers themselves are increasing steadily and exceeded 4000 in the past several years. About 95% of total facilities responded to patient survey. Moreover, more than 98% of facilities responded to facility survey. This figure was modified from the data that appeared in the preface of the Japanese version of the annual report of each year with permission of CRDR. CRDR, The Committee of Renal Data Registry of the Japanese Society for Dialysis Therapy.

Figure 2

Distribution of the patients by age strata. (a) For prevalent patients, the mode of age strata is 60–64 years both for male and and female patients. The proportion was larger for female patients over 75 years of age. (b) For incident population, 75–79 years old strata are the most populous for both male and female patients. Pale bar and filled bar represent male and female patients, respectively.

Figure 3

Trend of population by age. Numbers of the prevalent dialysis patients are increasing. Trend of age distribution demonstrates that the increase of the total population is due to the increase of the patients over 60 years of age.

Figure 4

Proportion of primary diagnoses of ESRD. Diabetes is most predominant in primary diagnosis of end-stage renal disease (ESRD) both for (a) the incident population as well as (b) the prevalent population. Patients with ESRD due to hypertension are also increasing. GN, glomerulonephritis; PKD, polycystic kidney disease.

Figure 5

Trend of causes of death. (a) Heart failure is the leading cause of death in prevalent patients, whereas the population who die from infection is also growing. (b) For incident patients, the proportion of patients that died from infection is larger than that of prevalent patients, and is almost the same as that of heart failure.

Figure 6

Trends of crude cumulative survival rates by the year of initiation. The survival rates during the shorter period less than 15 years are improving. However, those of the longer than 15 years are declining, probably due to the fact that the population is aging.