Factors associated with the incidence of dialysis

Abstract

There are regional differences in the incidence of dialysis, but few studies have investigated the reasons for such differences. We stratified 81 factors by gender for each of the 47 prefectures in Japan using the Japanese Society for Dialysis Therapy database of 102,011 patients who started chronic dialysis during 2004-2006. The age-adjusted average annual incidence of dialysis was 265.6±38.9 per million population. Among the 81 factors tested, 30 showed significant correlations with the incidence of dialysis among males, and 36 among females by univariate regression analysis. Among those factors, multivariate regression analysis showed that the average duration of hospitalization, the mortality rate from malignancy, a history of leg amputation, and duration of sunshine were extracted as determinants of the incidents of dialysis among males, and a history of acute myocardial infarction, mortality rate from lifestyle-related diseases, vitamin C intake, mortality rate from malignancy, amount of family saving, number of dialysis specialists, birth rate, days of snow, potatoes intake, average annual temperature, average duration of hospitalization, protein intake, and mortality rate from cerebrovascular disease were extracted among females. Many environmental factors were correlated with regional differences in the incidence of dialysis.