A nationwide prospective cohort study of patients with advanced chronic kidney disease in Japan: The Reach-J CKD cohort study
A nationwide prospective cohort study of patients with advanced chronic kidney disease in Japan: The Reach-J CKD cohort study
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DOI：
10.1007/s10157-017-1453-2
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发表时间：
2018-04-01
影响因子：
2.3
通讯作者：
Yamagata, Kunihiro
中科院分区：
文献类型：
--
作者：
Hoshino, Junichi;Nagai, Kei;Yamagata, Kunihiro
日本晚期慢性肾脏病(CKD)患者的流行病学和预后--估计的肾小球滤过率(EGFR)和45毫升/分钟/1.73米(2)--基本上仍未被检查。我们进行了一项全国性的调查，以确定日本慢性肾脏病患者的分布，并正在对这些患者进行队列研究。向所有有肾病专家的诊所/医院发送了一份问卷，详细介绍了设施及其慢性肾脏病的做法。基于调查结果，我们招募了2400名接受肾病医生护理的晚期CKD患者，这些患者来自日本各地至少30家有代表性的机构，按地区和设施规模随机分层选择。通过患者问卷和肾病学家-实践调查与国际慢性肾脏病结局和实践模式研究(CKDOPS)保持一致，我们将每年或半年前瞻性地收集患者、医生和临床数据，详细描述5年来的CKD实践，主要结果是死亡或肾脏替代治疗开始，次要结果是EGFR下降30%或50%，CKD进展到CKD G5，或心血管事件。在790个合格的反应机构中，330(41.8%)在平均3个月的时间内治疗了80名晚期CKD患者。这些设施的区域分布与一般人口中的人口分布相似。因此，选择用于数据收集的30家机构在日本似乎具有地理代表性。我们的研究将增进对各种CKD实践和与CKD进展相关的生物学数据的了解，并允许使用CKDavps平台进行国际比较。这将为改善晚期CKD患者的健康和生活质量提供依据。
Epidemiology and outcomes of Japanese patients with advanced chronic kidney disease (CKD)-an estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m(2)-has remained largely unexamined.We conducted a nationwide survey to determine the distribution of Japanese CKD patients, and are conducting a cohort study of these patients. A questionnaire eliciting details about facilities and their CKD practices was sent to all clinics/hospitals with nephrologists. Based on the survey results, we recruited 2400 advanced CKD patients receiving nephrologist care from at least 30 representative facilities throughout Japan, selected randomly with stratification by region and facility size. Through patient questionnaires and nephrologist-practice surveys aligned with the international CKD Outcomes and Practice Patterns Study (CKDopps), we shall annually or semi-annually collect patient, physician and clinic data prospectively, detailing CKD practices for 5 years, with a primary outcome of death or renal replacement therapy initiation, and secondary outcomes being decline of eGFR by 30% or 50%, CKD progression to CKD G5, or a cardiovascular event.Of 790 eligible, responding facilities, 330 (41.8%) treat ae80 advanced CKD patients in the average 3-month period. Regional distribution of these facilities is similar to that of persons in the general population. Hence, the 30 facilities selected for data collection appear to be geographically representative in Japan.Our study will enhance understanding of various CKD practices and biological data associated with CKD progression, and allow international comparisons using the CKDopps platform. This will provide evidences to improve the health and quality of life for patients with advanced CKD.