Molecular genetic analysis of various types of complications in patients with long-term dialysis therapy

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The aim of this study was to investigate the association of genetic polymorphisms and various types of complications in dialysis patients and to explore new molecular targets for these disorders.About 4,500 patients are currently receiving hemodialysis therapy in Niigata prefecture, and, the proportion of the patients, who have been hemodialysed for 20 years or more, is more than 8.5%, which is the highest in this country. Moreover, 15.5% of cases under long-term hemodialysis for more than 30 years in this country are in our prefecture.We have collected detailed clinical data and genomic DNA of long-term hemodialysis patients in Niigata prefecture and analyzed multiple genetic polymorphisms, including genes for inflammatory cytokines, lipid metabolism, calcium metabolism, and vasoactive peptides. We are following them up in order to determine their survival, and to record any dialysis associated complications particularly dialysis-associated amyloidosis, complications of bone / joint, and cardiovascular events, as well as uremic pruritus.We have reported that various genetic polymorphisms are associated with the onset of dialysis-associated amyloidosis and cardiovascular complications in hundreds patients with hemodialysis. ). Moreover, we have investigated the risk factors for severe uremic pruritus in a large-population (N = 2,400) of patients under maintenance hemodialysis and found that severe uremic pruritus was independently associated with poor outcome even after adjusting for other significant clinical risk factors in these patients (Narita I, et al. Kidney Int, 2006). We also have reported a prospective study of patients with long-term hemodialysis treatment (Ajiro J, et al. Clin J Am Soc Nephrol, 2007)