Age- and gender-specific incidence rates of renal replacement therapy in Japan: an international comparison
Age- and gender-specific incidence rates of renal replacement therapy in Japan: an international comparison
复制标题
日本肾脏替代治疗的年龄和性别发病率：国际比较
作者：
M. Wakasugi;J. Kazama;I. Narita
日本0-19岁人群中终末期肾病（ESKD）的肾脏替代治疗（RRT）发生率相对较低，但老年人群的发生率相对较高。另一方面，澳大利亚0-19岁年龄组的比率相对较高，但年龄较大的年龄组的比率相对较低。因此，日本和澳大利亚之间的国际比较将是有益的。本研究旨在比较日本RRT的年龄和性别特异性发病率与澳大利亚ESKD的总发病率，包括开始RRT的患者和未接受RRT而死于ESKD的患者，以更好地了解ESKD的负担，与RRT接受率的差异无关。我们还比较了日本的发病率与两个主要登记处，美国肾脏数据系统（USRDS）和欧洲肾脏协会，欧洲透析和移植协会（ERA-EDTA）的公布数据。MethodsData在日本启动RRT的患者人数从日本透析治疗学会（JSDT）登记处在2003-2007年和2011年公布的数据中提取。通过将每个年龄-性别类别的发病患者数量除以相应人群的总人数，计算年龄和性别特异性发病率。其他国家的发病率摘自澳大利亚发表的论文、USRDS 2011年年度报告和ERA-EDTA 2011年年度报告中的表格。结果在50至69岁的男性中，日本RRT的发病率约为澳大利亚ESKD总发病率的2倍。与发病率的RRT报告的USRDS和ERA-EDTA相比，日本男性有类似或大幅提高率，分别conclusionsJapan有较高的发病率RRT中，老年人群相比，在澳大利亚的ESKD的总发病率。由于澳大利亚的数据包括治疗和未治疗的ESKD，因此RRT接受率的差异无法解释日本的较高发生率。有必要制定一项针对中老年男性的策略，以降低日本RRT的发生率。
BackgroundJapan has relatively low incidence rates of renal replacement therapy (RRT) for end-stage kidney disease (ESKD) among those aged 0–19 years, but relatively high rates for the older age band. On the other hand, Australia has relatively high rates among those aged 0–19 years, but relatively low rates for the older age band. Thus, an international comparison between Japan and Australia would be informative. This study aimed to compare age- and gender-specific incidence rates of RRT in Japan with the total incidence of ESKD in Australia, which includes both those who start RRT and those who died of ESKD without RRT, in order to better understand the burden of ESKD independently of differences in the acceptance rate of RRT. We also compared incidence rates in Japan with published data from two major registries, the United States Renal Data System (USRDS) and the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA).MethodsData on numbers of patients who initiated RRT in Japan were extracted from data published by the Japanese Society of Dialysis Therapy (JSDT) Registry in 2003–2007 and 2011. Age- and gender-specific incidence rates were calculated by dividing the number of incident patients for each age-gender category by the total number of people in the corresponding population. Incidence in other countries was extracted from a published paper in Australia, tables in the USRDS annual report 2011, and the ERA-EDTA annual report 2011.ResultsAmong males aged 50 to 69 years, incidence rates of RRT in Japan were about two times the total incidence of ESKD in Australia. Compared with the incidence rates of RRT reported by the USRDS and the ERA-EDTA, Japanese males have similar or substantially higher rates, respectively.ConclusionsJapan has a higher incidence of RRT among middle- and older-aged populations compared to the total incidence rates of ESKD in Australia. This higher incidence in Japan cannot be explained by differences in the acceptance rate for RRT since data from Australia included both treated and untreated ESKD. A strategy that targets middle- and older-aged males will be necessary to decrease the incidence of RRT in Japan.