Age- and gender-specific incidence rates of renal replacement therapy in Japan: an international comparison

Abstract

Japan has relatively low incidence rates of renal replacement therapy (RRT) for end-stage kidney disease (ESKD) among those aged 0–19 years, but relatively high rates for the older age band. On the other hand, Australia has relatively high rates among those aged 0–19 years, but relatively low rates for the older age band. Thus, an international comparison between Japan and Australia would be informative. This study aimed to compare age- and gender-specific incidence rates of RRT in Japan with the total incidence of ESKD in Australia, which includes both those who start RRT and those who died of ESKD without RRT, in order to better understand the burden of ESKD independently of differences in the acceptance rate of RRT. We also compared incidence rates in Japan with published data from two major registries, the United States Renal Data System (USRDS) and the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA). Data on numbers of patients who initiated RRT in Japan were extracted from data published by the Japanese Society of Dialysis Therapy (JSDT) Registry in 2003–2007 and 2011. Age- and gender-specific incidence rates were calculated by dividing the number of incident patients for each age-gender category by the total number of people in the corresponding population. Incidence in other countries was extracted from a published paper in Australia, tables in the USRDS annual report 2011, and the ERA-EDTA annual report 2011. Among males aged 50 to 69 years, incidence rates of RRT in Japan were about two times the total incidence of ESKD in Australia. Compared with the incidence rates of RRT reported by the USRDS and the ERA-EDTA, Japanese males have similar or substantially higher rates, respectively. Japan has a higher incidence of RRT among middle- and older-aged populations compared to the total incidence rates of ESKD in Australia. This higher incidence in Japan cannot be explained by differences in the acceptance rate for RRT since data from Australia included both treated and untreated ESKD. A strategy that targets middle- and older-aged males will be necessary to decrease the incidence of RRT in Japan.