Evidence map›Paper›PMID 34649519›Full record

ArticleBMC nephrology2021

Changes in practice patterns in Japan from before to after JSDT 2013 guidelines on hemodialysis prescriptions: results from the JDOPPS.

Tadashi Tomo, Maria Larkina, Ayumi Shintani, Tomonari Ogawa, Bruce M Robinson, Brian Bieber, Lisa Henn, Ronald L Pisoni

Open access · goldAbstract read
In one paragraph

Article in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Tadashi TomoClinical Engineering Research Center, Oita University, 5593 Idai-gaoka,1-1, Hasama-machi, Yufu-City, Oita, Japan. tomo@oita-u.ac.jp.
Maria LarkinaArbor Research Collaborative for Health, Ann Arbor, USA.
Ayumi ShintaniDepartment of Medical Statistics, Graduate School of Medicine Osaka City University, Osaka, Japan.
Tomonari OgawaDepartment of Nephrology and Blood Purification Center Saitama Medical Center, Medical University, Saitama, Japan.
Bruce M RobinsonArbor Research Collaborative for Health, Ann Arbor, USA.
Brian BieberArbor Research Collaborative for Health, Ann Arbor, USA.
Lisa HennArbor Research Collaborative for Health, Ann Arbor, USA.
Ronald L PisoniArbor Research Collaborative for Health, Ann Arbor, USA.
Arbor Research Collaborative for Health · USOita University · JPOsaka City University · JPSocial Insurance Saitama Chuo Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Japanese Society for Dialysis Therapy (JSDT) published in 2013 inaugural hemodialysis (HD) guidelines. Specific targets include 1.4 for single-pool Kt/V (spKt/V) with a minimum dose of 1.2, minimum dialysis session length of 4 hours, minimum blood flow rate (BFR) of 200 mL/min, fluid removal rate no more than 15 mL/kg/hr, and hemodiafiltration (HDF) therapy for certain identified symptoms. We evaluated the effect of these guidelines on actual practice in the years spanning 2005 - 2018.

methodsAnalyses were carried out to describe trends in the above HD prescription practices from December 2005 to April 2013 (before guideline publication) to August 2018 based on prevalent patient cross-sections from approximately 60 randomly selected HD facilities participating in the Japan Dialysis Outcomes and Practice Patterns Study.

resultsFrom April 2006 to August 2017 continual rises occurred in mean spKt/V (from 1.35 to 1.49), and percent of patients having spKt/V>1.2 (71% to 85%). Mean BFR increased with time from 198.3 mL/min (April 2006) to 218.4 mL/min (August 2017) , along with percent of patients with BFR >200 ml/min (65% to 85%). HDF use increased slightly from 6% (April 2006 and August 2009) to 8% by April 2013, but increased greatly thereafter to 23% by August 2017. In contrast, mean HD treatment time showed little change from 2006-2017, whereas mean UFR declined from 11.3 in 2006 to 8.4 mL/Kg/hour in 2017.

conclusionsFrom 2006 - 2018 Japanese HD patients experienced marked improvement in reaching the spKt/V target specified by the 2013 JSDT guidelines. This may have been due to moderate increase in mean BFR even though mean HD session length did not change much. In addition, HDF use increased dramatically in this time period. Other HD delivery changes during this time, such as increased use of super high flux dialyzers, also merit study. While we cannot definitively conclude a causal relationship between the publication of the guidelines and the subsequent practice changes in Japan, those changes moved practice closer to the recommendations of the guidelines.

Indexed as

Practice Guidelines as TopicAgedFemaleHumansJapanMaleMiddle AgedPractice Patterns, Physicians'PrescriptionsRenal Dialysisblood flow ratedialysis adequacyguidelineshemodiafiltrationHemodialysisKt/V

Identifiers

PMID34649519
PMCPMC8518149
OpenAlexW3205225754

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.