Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 21

Several recent articles have provided important evidence that the incidence of SCD in Japanese dialysis patients is higher than we previously thought. First, the Dialysis Outcomes and Practice Patterns Study [7] provided evidence in 2012 that 21% of 569 death events among Japanese HD patients were caused by SCD, which is nearly equal to the rates reported from other countries. This finding may imply that differences in practice patterns between countries are not related to differences in the incidence of SCD. The second article from a Japanese multicenter study, named the B-SAFE-study [8], which was conducted by cardiologists who entered 677 Japanese HD patients and then followed them for 3 years, reported 125 deaths during the follow-up period. When the cardiologists confirmed the causes of death, 16% were SCD. The other article is a small single-center study. The study enrolled 224 new HD patients without cardiac disease, and 77 of them died during a mean follow-up period of 5.5 years, with about 10% of the deaths due to SCD [9]. It is noteworthy that a relatively high incidence (10%) of SCD was observed even in HD patients without clinically manifest cardiac disease. Moreover, Nishimura et al. [6] have also confirmed high incidence of SCD in 3 observational studies of maintenance HD patients. During the mean follow-up period of 2.7 years, 19 patients died with about 74% of the deaths due to SCD in 90 HD patients after percutaneous coronary interventions. The study enrolled 155 HD patients without significant coronary artery disease, and 63 of them died during a mean follow-up period of 5.0 years, with about 27% of the deaths due to SCD [5]. In 175 HD patients with left ventricular hypertrophy, 82 died during a mean follow-up period of 4.5 years, with about 28% defined as SCD [4]. Taking these studies into account, it would appear that SCD is more common in the Japanese dialysis clinical setting than was previously thought, and its incidence in Japan appears to be similar to that in other countries. However, the reasons for the earlier differences are not well understood. One of the reasons may be the lack of a universally accepted, precise definition of SCD.