Public support for patients with intractable diseases in Japan: impact on clinical indicators from nationwide registries in patients with autosomal dominant polycystic kidney disease.

Autor: Kataoka H; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan., Shimada Y; Intelligent Systems Laboratory, SECOM CO., LTD. Mitaka, Tokyo, Japan.; Department of Medical Eleactronic Intelligence Management, Juntendo University Graduate School of Medicine, Tokyo, Japan., Kimura T; Reverse Translational Research Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Osaka, Japan., Nishio S; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan., Nakatani S; Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan., Mochizuki T; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.; PKD Nephrology Clinic, Tokyo, Japan., Tsuchiya K; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.; Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan., Hoshino J; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan., Hattanda F; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan., Kawano H; Department of Urology, Department of Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan., Hanaoka K; Department of General Internal Medicine, The Jikei University, Tokyo, Japan., Hidaka S; Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kanagawa, Japan., Ichikawa D; Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kanagawa, Japan., Ishikawa E; Department of Internal Medicine, Saiseikai Matsusaka General Hospital, Mie, Japan., Uchiyama K; Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan., Hayashi H; Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan., Makabe S; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan., Manabe S; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan., Mitobe M; Department of Nephrology, Takeda General Hospital, Fukushima, Japan., Sekine A; Department of Nephrology, Toranomon Hospital, Tokyo, Japan., Suwabe T; Department of Nephrology, Toranomon Hospital, Tokyo, Japan., Kai H; Pathophysiology of Renal Diseases, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan., Kurashige M; Nephrology and Hypertension, Department of Internal Medicine, The Jikei University, Tokyo, Japan., Seta K; Department of Nephrology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan., Shimazu K; Department of Nephrology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan., Moriyama T; Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan., Sato M; Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan., Otsuka T; Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan., Katayama K; Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Mie, Japan., Shimabukuro W; Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Fujimaru T; Department of Nephrology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, Japan., Miura K; Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan., Nakanishi K; Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Horie S; Department of Urology, Department of Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan., Furuichi K; Department of Nephrology, Kanazawa Medical University, Ishikawa, Japan., Okada H; Department of Nephrology, Saitama Medical University, Saitama, Japan., Narita I; Division of Clinical Nephrology and Rheumatology, Niigata University, Niigata, Japan., Muto S; Department of Urology, Juntendo University Nerima Hospital, Tokyo, Japan. s-muto@juntendo.ac.jp.
Jazyk: angličtina
Zdroj: Clinical and experimental nephrology [Clin Exp Nephrol] 2023 Oct; Vol. 27 (10), pp. 809-818. Date of Electronic Publication: 2023 Jun 27.
DOI: 10.1007/s10157-023-02372-8
Abstrakt: Background: Clinical practice guidelines recommend antihypertensive and tolvaptan therapies for patients with autosomal dominant polycystic kidney disease (ADPKD) in Japan. However, tolvaptan therapy may pose an economic burden. The Japanese Ministry of Health, Labour and Welfare supports patients with intractable diseases. This study aimed to confirm the impact of the intractable disease system in Japan on the clinical treatment of ADPKD.
Methods: We analyzed the data of 3768 patients with ADPKD having a medical subsidy certificate from the Japanese Ministry of Health, Labour and Welfare in 2015-2016. The following quality indicators were use: the adherence rate to the 2014 clinical practice guideline for polycystic kidney disease (prescription rates of antihypertensive agents and tolvaptan in this cohort) and the number of Japanese patients with ADPKD nationwide started on renal replacement therapy in 2014 and 2020.
Results: Compared with new applications from 2015 to 2016, the prescription rates of antihypertensives and tolvaptan for the indicated patients at the 2017 renewal application increased by 2.0% (odds ratio = 1.41, p = 0.008) and 47.4% (odds ratio = 10.1, p > 0.001), respectively. These quality indicators improved with antihypertensive treatment, especially in patients with chronic kidney disease stages 1-2 (odds ratio = 1.79, p = 0.013) and in those aged < 50 years (odds ratio = 1.70, p = 0.003). The number of patients with ADPKD who were started on renal replacement therapy in Japan decreased from 999 in 2014 to 884 in 2020 in the nationwide database (odds ratio = 0.83, p < 0.001).
Conclusions: The Japanese public intractable disease support system contributes to improvement of ADPKD treatment.
(© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.)
Databáze: MEDLINE
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