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Causes of death in patients undergoing maintenance hemodialysis in Japan: 10-year outcomes of the Q-Cohort Study

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Clinical and Experimental Nephrology Aims and scope Submit manuscript

Abstract

Background

Although the mortality rate in patients on hemodialysis remains extremely high, detailed information on causes of death over long-term periods is limited. The aim of this study was to clarify the underlying causes of death in patients undergoing maintenance hemodialysis in Japan.

Methods

This was a 10-year, multicenter, observational study of 3528 outpatients undergoing maintenance hemodialysis in Japan. Clinical outcomes were analyzed and causes of death were classified into six broad categories including cardiovascular diseases, infectious diseases, malignant neoplasms, cachexia, trauma/accidents, and other diseases, and more detailed subcategories.

Results

During the 10-year follow-up period, 1748 (49.5%) patients died. The most frequent causes of death were cardiovascular diseases (36.1%), followed by infectious diseases (25.8%) and malignant neoplasms (13.5%). In a detailed classification, sudden death, pulmonary infection, and lung cancer were the most common causes of death in cardiovascular diseases, infectious diseases, and malignant neoplasms, respectively.

Conclusion

Our study determined details on causes of death in Japanese hemodialysis patients during the 10-year follow-up period. Cardiovascular disease, especially sudden death is noticeable cause of death among patients on hemodialysis.

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Acknowledgements

We thank Richard Robins, Ph.D., from Edanz Group (https://www.jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

This study was supported by the Kidney Foundation (H19 JKFB 07–13, H20 JKFB 08–8, H23 JKFB 11–11) and the Japan Dialysis Outcome Research Foundation (H19-076–02, H20-003). The funders of this study had no role in study design including collection, analysis, and interpretation of data; writing of the report; or the decision to submit the report for publication. The authors declare that they have no relevant financial interests.

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Authors and Affiliations

  1. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3–1–1 Maidashi, Higashi-Ku, Fukuoka, 8128582, Japan

    Hiroto Hiyamuta, Shunsuke Yamada, Toshiaki Nakano & Takanari Kitazono

  2. Fukuoka Renal Clinic, Fukuoka, Japan

    Masatomo Taniguchi

  3. Department of Nephrology, Nara Medical University, Nara, Japan

    Kazuhiko Tsuruya

Authors
  1. Hiroto Hiyamuta
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  2. Shunsuke Yamada
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  3. Masatomo Taniguchi
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  4. Toshiaki Nakano
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  5. Kazuhiko Tsuruya
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  6. Takanari Kitazono
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Contributions

The individual contributions of each co-author were as follows. HH contributed to the study design, statistical analysis, interpretation of data, and drafting of the manuscript. SY contributed to the study design, statistical analysis, interpretation of data, and drafting of the manuscript. MT contributed to acquisition of data and critical revision of the manuscript. TN contributed to funding, acquisition of data, and critical revision of the manuscript. KT and TK contributed to critical revision of the manuscript and supervision of the study. All authors provided critical reviews of the draft and approved the final version.

Corresponding author

Correspondence to Toshiaki Nakano.

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Conflict of interest

The authors declare no conflicts of interest as described by Clinical and Experimental Nephrology.

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Hiyamuta, H., Yamada, S., Taniguchi, M. et al. Causes of death in patients undergoing maintenance hemodialysis in Japan: 10-year outcomes of the Q-Cohort Study. Clin Exp Nephrol 25, 1121–1130 (2021). https://doi.org/10.1007/s10157-021-02089-6

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  • DOI: https://doi.org/10.1007/s10157-021-02089-6

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