Patient Selection and Prescription of On-Line HDF in Japan

Abstract

Renal replacement therapy for end-stage kidney disease can be achieved by several interventions including hemodialysis (HD), hemodiafiltration (HDF), peritoneal dialysis (PD) and kidney transplantation, and others. The December 31, 2011 prevalent population included 270,072 patients on HD, 9,094 on PD and 14,051 on HDF; the total treated ESRD population thus rose above 300,000. In contrast, the number of HDF patients decreased after 2007, one of the reasons for Japan's health insurance system. On-line HDF patients were preferentially selected because of their younger age, longer vintage and their lower clinical comorbidity conditions than HD or off-line HDF patients. However, on-line HDF was approved by Japan's health insurance system in 2012. Owing to this approval the number of on-line HDFs may increase in the future.