Clinical and Experimental Nephrology

, Volume 20, Issue 6, pp 918–925 | Cite as

Transition of adolescent and young adult patients with childhood-onset chronic kidney disease from pediatric to adult renal services: a nationwide survey in Japan

  • Motoshi HattoriEmail author
  • Masayuki Iwano
  • Mayumi Sako
  • Masataka Honda
  • Hirokazu Okada
  • Yuko Akioka
  • Akira Ashida
  • Yukihiko Kawasaki
  • Hideyasu Kiyomoto
  • Yoshio Terada
  • Daishi Hirano
  • Mikiya Fujieda
  • Shouichi Fujimoto
  • Takao Masaki
  • Shoichi Maruyama
  • Seiich Mastuo
Original Article



Transition of adolescent and young adult (AYA) patients with childhood-onset chronic kidney diseases (C-CKD) from pediatric to adult renal services has received increasing attention. However, information on transition of Japanese patients with C-CKD is limited.


The Transition Medicine Working Group, in collaboration with the Japanese Society for Nephrology, the Japanese Society for Pediatric Nephrology and the Japanese Society of Pediatric Urology, conducted a retrospective cross-sectional study in 2014 on issues concerning the transition of Japanese patients with C-CKD.


Few institutions in Japan had transition programs and/or transition coordinators for patients with C-CKD. Refusal to transfer by patients or their families, lack of concern about transition and inability to decide on transfer were common reasons for non-transfer of patients still followed by pediatric renal services. Around 25 % of patients who had ended or interrupted follow-up by pediatric renal services presented to adult renal services because of symptoms associated with C-CKD. Patients with various types of childhood-onset nephrourological diseases were transferred from pediatric to adult renal services. IgA nephropathy, minimal change nephrotic syndrome and congenital anomalies of the kidney and urinary tract were the most frequent primary kidney diseases in adult patients with C-CKD.


These survey results indicate the need for introduction of transitional care for Japanese AYA patients with C-CKD. Consensus guidelines for the optimal clinical management of AYA patients with C-CKD are required to ensure the continuity of care from child to adult renal services.


Transition Childhood-onset chronic kidney disease Adolescent and young adult patients Pediatric renal services Adult renal services 



This study was supported in part by a Grant-in-Aid for Intractable Renal Diseases Research, Research on rare and intractable disease, Health and Labour Sciences Research Grants from the Ministry of Health, Labour and Welfare of Japan. The authors thank all patients, families, physicians, and institutes who contributed to the transition survey. The authors also thank the council members of the Japanese Society for Nephrology (JSN), the Japanese Society for Pediatric Nephrology (JSPN), and the Japanese Society of Pediatric Urology (JSPN) for their contributions to data collection. The authors also thank Prof. Yasuo Ohashi, Mr. Masayuki Kurihara, and Ms. Chie Matsuda of the Japan Clinical Research Support Unit (Tokyo) for their help with data management.

Compliance with ethical standards

Conflict of interest

Motoshi Hattori has received a research grant from Astellas Pharma and Chugai Pharma. Masayuki Iwano has received lecture fees from Otsuka Pharma and has a research grant from Otsuka Pharma, Astellas Pharma and Eli Lilly Japan. Hirokazu Okada has received a research grant from Chugai Pharma, Torii Pharma and Takeda Pharma. Yoshio Terada has received a research grant from Chugai Pharma and Daiichi Sankyo Pharma. Shouichi Fujimoto has received a research grant from Chugai Pharma, Dainippon Sumitomo Pharma and Nikkiso. Takao Masaki has received lecture fees from Chugai Pharma and Mitsubishi Tanabe Pharma and has a research grant from Asahi Kasei Pharma, Astellas Pharma, Genzyme, Otsuka Pharma, Kyowa Hakko Kirin, JMS, Mochida Pharma, Mitsubishi Tanabe Pharma, Takeda Pharma, Terumo, Torii Pharma, Daiichi Sankyo Pharma, Bayer Yakuhin and Baxter. Shoichi Maruyama has a research grant from Astellas Pharma, Alexion Pharma, Genzyme, Otsuka Pharma, Kyowa Hakko Kirin, Daiichi Sankyo Pharma, Dainippon Sumitomo Pharma, Takeda Pharma and Torii Pharma. Seiichi Matsuo has a research grant from Astellas Pharma, Alexion Pharma, Daiichi Sankyo Pharma, Otsuka Pharma, Kyowa Hakko Kirin, MSD, Baxter, Dainippon Sumitomo Pharma, Boehringer Ingelheim Japan, Takeda Pharma, Mitsubishi Tanabe Pharma, Teijin Pharm, Mochida Pharma and Torii Pharma. Drs Sako, Honda, Akioka, Ashida, Kawasaki, Kiyomoto, Hirano, and Fujieda have no conflicts of interest to declare.


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Copyright information

© Japanese Society of Nephrology 2016

Authors and Affiliations

  • Motoshi Hattori
    • 1
    Email author
  • Masayuki Iwano
    • 2
  • Mayumi Sako
    • 3
  • Masataka Honda
    • 4
  • Hirokazu Okada
    • 5
  • Yuko Akioka
    • 1
  • Akira Ashida
    • 6
  • Yukihiko Kawasaki
    • 7
  • Hideyasu Kiyomoto
    • 8
  • Yoshio Terada
    • 9
  • Daishi Hirano
    • 10
  • Mikiya Fujieda
    • 11
  • Shouichi Fujimoto
    • 12
  • Takao Masaki
    • 13
  • Shoichi Maruyama
    • 14
  • Seiich Mastuo
    • 14
  1. 1.Department of Pediatric NephrologyTokyo Women’s Medical University, School of MedicineTokyoJapan
  2. 2.Division of Nephrology, Department of MedicineSchool of Medicine, Faculty of Medical Sciences, University of FukuiFukuiJapan
  3. 3.Division for Clinical Trials, Department of Clinical ResearchCenter for Clinical Research and Development, National Center for Child Health and DevelopmentTokyoJapan
  4. 4.Department of NephrologyTokyo Metropolitan Children’s Medical CenterTokyoJapan
  5. 5.Department of Nephrology and General Internal MedicineSaitama Medical UniversitySaitamaJapan
  6. 6.Department of PediatricsOsaka Medical CollegeOsakaJapan
  7. 7.Department of Pediatrics, Division of Medical ScienceFukushima Medical University School of MedicineFukushimaJapan
  8. 8.Department of Community Medical SupportsTohoku Medical Megabank OrganizationSendaiJapan
  9. 9.Department of Endocrinology, Metabolism and NephrologyKochi Medical SchoolKochiJapan
  10. 10.Department of PediatricsJikei University School of MedicineTokyoJapan
  11. 11.Department of PediatricsKochi Medical SchoolKochiJapan
  12. 12.Department of Hemovascular Medicine and Artificial OrgansUniversity of MiyazakiKochiJapan
  13. 13.Department of NephrologyHiroshima University HospitalHiroshimaJapan
  14. 14.Department of NephrologyNagoya University Graduate School of MedicineNagoyaJapan

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