Presidential Address Upon Appointment to the Japanese Society for Dialysis Therapy

Abstract

JSDT was founded in 1968 as the Society for the Study of Dialysis (Jinkou Touseki Igakukai), a private academic society. In 1985, it was renamed the Japanese Society for Dialysis Therapy (Nihon Touseki Ryouhou Gakkai). In 1993, it was approved as an incorporated association, the Japanese Society for Dialysis Therapy (Nihon Touseki Igakukai). On 3 September 2012, in accordance with the reforming of public service corporations, it became a general incorporated association, one of the largest academic societies in Japan with over 16 000 members comprising regular, institutional, and supporting members. I hope to work towards the smooth transition to a new corporation as well as for the development of research and promotion of knowledge on dialysis and related medicine to contribute widely to patients and society. In recent clinical research, it has been identified that degradation of renal function increases the risk of cerebrovascular disorders, coronary artery disease, myocardial infarction, and cardiac failure, as well as the risk of death and hospitalization due to cerebrovascular disorders. However, blood purification for patients with chronic renal failure is inadequate in terms of both quality and quantity to achieve the effect of a normal renal function, and patients are constantly exposed to the above-mentioned risks. Therefore, to improve the prognosis of patients with chronic renal failure, it is necessary to develop and provide a better blood purification service. I believe that the problems to solve and our therapeutic strategies will be identified through looking back over the 40-year history of blood purification and resolving major problems, such as those related to urotoxin removal, biocompatibility of the dialysis membrane, dialysis fluid, vascular access, malnutrition, arteriosclerosis, and aging. Based on such a perspective, I would like to establish a committee to study new technologies that can improve the existing blood purification system as well as create guidelines for dialysis therapy for properly conducting blood purification using practicable technologies and guidelines for the nutritional care of dialysis patients, which is one of the most important issues in dialysis therapy. As one of the problems in the treatment of chronic renal failure in Japan, it has been pointed out that the number of patients who undergo peritoneal dialysis or renal transplantation is extremely low compared to Western countries in spite of having the world's highest proportion of patients receiving dialysis as a percentage of the population. To provide well-balanced medical treatment for chronic renal failure, it is important to provide patients with a choice of three therapeutic methods, which are dialysis, peritoneal dialysis, and renal transplantation. It has been reported that the option of renal transplantation has been given to only 30% of the patients and peritoneal dialysis to only 50%. We would like to establish a well-balanced medical care system for chronic renal failure according to the therapeutic methods required for each patient by promoting knowledge of the three therapeutic methods in cooperation with other organizations, such as the Japanese Society of Nephrology, Japan Society for Transplantation, Japanese Society for Clinical Renal Transplantation, and Japanese Society for Peritoneal Dialysis. Another major problem is the declining number of young clinicians who treat chronic renal failure and young researchers who study dialysis medicine. To treat Japan's 300 000 patients with chronic renal failure and further develop dialysis medicine, it is vital to nurture ambitious young doctors. We plan to provide seminars on blood purification for young doctors involving residents and other young doctors in order to promote their interest in dialysis medicine. We hope to contribute to securing human resources in dialysis medicine by helping young doctors deepen their understanding of maintenance dialysis as well as acute blood purification, which has become essential in emergency medical services. To manage the JSDT effectively, it is important to facilitate both the activities of its standing committees and cooperation with related academic societies. With regard to this, we would like to manage JSDT activities to cooperate and share duties with other organizations, such as the Japanese Society of Nephrology, The Japan Society for Transplantation, Japanese Society for Clinical Renal Transplantation, Japanese Society for Peritoneal Dialysis, The Japan Diabetes Society, Japanese Association of Dialysis Physicians, Japan Academy of Nephrology Nursing, and Japan Association for Clinical Engineers. Further, to facilitate team medical care in the field of dialysis, we plan to provide education and training for nurses, clinical engineers, pharmacists, nutritionists, and other people of related occupations in cooperation with related organizations. I will make my best effort to resolve these issues during my term. I would appreciate the support of JSDT members as well as the members of related academic societies, organizations, and companies.