-Report on Experiments and Clinical Cases-

History and Current Practice of Blood Purification Therapy in Nippon Medical School Musashi Kosugi Hospital: 31 Years of Practice

Yukinao Sakai¹, Yutaka Kadomatsu², Saori Sakai¹, Tomoyuki Otsuka¹, Dai Ohno¹, Tsuneo Murasawa¹, Naoki Sato^1,3 and Kyoichi Mizuno³

¹Division of Nephrology, Department of Internal Medicine, Nippon Medical School Musashi Kosugi Hospital
²Department of Medical Engineering, Nippon Medical School Musashi Kosugi Hospital
³Division of Cardiology, Hepatology, Geriatrics and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School

Introduction: Renal replacement therapy was established in Japan approximately 40 years ago, and a blood purification unit was established in our hospital 31 years ago. With an eye toward the future, we reviewed and analyzed the practice of blood purification therapy in our hospital to date.
Methods: Patients were selected from 3 decades when therapy was performed: from October 1979 through December 1989, from January 1990 through December 1999, and from January 2000 through December 2010.
Results: The total number of patients was 1,115. The numbers of patients with stage 5D/T chronic kidney disease, with acute kidney injury, and undergoing therapeutic apheresis has increased with each decade. Diabetic nephropathy, chronic glomerulonephritis, and nephrosclerosis are the most frequent primary causes of stage 5D/T chronic kidney disease. The percentage of patients with diabetic nephropathy at our hospital has increased markedly and has recently been more than 50% and has exceeded the national average. The trends observed in our study for mean age at the start of dialysis therapy were similar to national trends. Peritoneal dialysis was started in 1999, and the percent of patients undergoing peritoneal dialysis greatly exceeded the national average. Various pathophysiologies were found to be associated with acute kidney injury and therapeutic apheresis.
Conclusion: The number of patients requiring renal replacement therapy continues to increase with the development of the hospital, especially in the Department of Nephrology. Progress in blood purification therapies is remarkable as well. To successfully address these challenges, we must strive for continued self-assessment.

J Nippon Med Sch 2012; 79: 357-361

Keywords
history, blood purification therapy, apheresis, hemodialysis, peritoneal dialysis

Correspondence to
Yukinao Sakai, Division of Nephrology, Department of Internal Medicine, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
y-sakai@nms.ac.jp

Received, August 26, 2011
Accepted, January 6, 2012