The urine test for proteinuria and hematuria is popular among Japanese people; however, the outcomes have not been well studied. Okinawa dialysis study (OKIDS) Chronic dialysis therapy was started in Okinawa in 1971, several years after it was initiated in other parts of Japan [3–5]. The number of dialysis patients per million population (pmp) is increasing faster in Okinawa than the national average (Fig. 1). The number was 1,982 in 1990 and 5,246 in 2000 when the population was 1.2 million (1990) and 1.3 million (2000), respectively. The number of dialysis units was 27
in 1990 and 56 in 2000. Initially, the objective of the OKIDS Androgen Receptor inhibitor was to determine the relative risk of CVD, including stroke and acute myocardial infarction, in dialysis patients. The strengths of the study are that all of the medical facilities have cooperated, and the data for the incidence of CVD in the general population were available at the same time in Okinawa. We found that the relative risk of stroke, in particular cerebral hemorrhage was very high, but not as high as acute myocardial infarction. The incidence of cerebral hemorrhage was higher than in the general
population, even for normotensive dialysis patients [6, 7]. Fig. 1 Prevalence of chronic dialysis patients per million population in Okinawa and Japan (cited from ref. ) We examined the effects of clinical and laboratory data from several sources on survival [8–18]. Among them, serum albumin was a strong Selleckchem CRT0066101 predictor of death, suggesting the importance of nutritional management . Heart failure has been the leading cause of death among dialysis patients. Our data suggest that factors Resveratrol other than atherosclerotic
heart disease lead to heart failure in the dialysis population. The overall survival was higher for those with a higher blood pressure and total serum cholesterol, which contradicts data from the general population. These observations were later recognized as ‘reverse epidemiology’ . Dialysis patients have multiple modifiable risk factors. Table 1 summarizes the factors related to poor survival in chronic dialysis patients . Table 1 Risk factors for death in chronic dialysis patients (modified from Iseki et al. CEN2004 ) Patient demographics Age Sex Primary renal disease (diabetes, nephrosclerosis) Predialysis comorbid conditions (cardiovascular disease, malignancies) Laboratory BV-6 clinical trial variables Hypertension Hypotension Hypoalbuminemia Hypocholesterolemia High CRP High coronary artery calcification score CKD-MBD Hyper- and hypophosphatemia Hypercalcemia Electrolyte disturbance Hyperpotassemia Hyponatremia Several randomized controlled trials, such as the treatment of anemia using an erythropoietin-stimulating agent [21, 22] and statin treatment [23, 24], have failed to show an improvement in survival.