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‘CKD49’- Approaches to Treat Patients with Chronic Kidney Disease in Cooperation with Medical Associations in 49 districts2014.06.11
Implementation of Health and Longevity by Cooperation of Basic, Social and Clinical Medical Sciences
Professor Kunihiro Yamagata, Faculty of Medicine
17 (17 faculty members, 0 postdoctoral fellows, none from other organizations)
medical cooperation, health science, life science, lifestyle-related diseases, home-based care
Do you know the term “chronic kidney disease (CKD)”? Approximately 13% (n=13.3 million) of Japanese adults have CKD. It can be caused or aggravated by lifestyle-related diseases, such as diabetes and respiratory illness, and is an important risk factor for cardiovascular disease and terminal renal failure. To treat CKD patients, cooperation between primary care physicians and nephrologists is important, and it is also crucial to improve their lifestyle. Given this situation, we established a research unit named the “Implementation of Health and Longevity by Cooperation of Basic, Social and Clinical Medical Sciences”, which conducts research on kidney diseases, mainly CKD, and lifestyle-related diseases (Figure 1).
Cooperation with medical associations in 49 districts in Japan
In our present study, we are investigating the utility of a medical care system aimed at preventing disease progression in CKD patients using a cluster randomization design in cooperation with primary care physicians and nephrologists from medical associations in 49 districts. Specifically, clusters of patients are divided into normal and intense intervention groups, and the latter group receives instructions on lifestyle, including dietary habits, from registered dietitians, and undergoes educational programs provided by multiple healthcare providers. These interventions are evaluated using specific indices (Figure 2). Based on the results of this study, researchers can generate ideas for creating appropriate policies regarding the treatment of CKD. In addition, this study may be able to contribute to shifting from hospital-based to home-based medical care for patients with severe CKD in Japan.
Efforts to achieve the standardization of systems to prevent and treat CKD *1
The results of our study obtained by March 2012, three and a half years after its initiation, revealed that the rate of patients returning to their primary care physicians after consulting nephrologists was higher in the intense intervention group. This group also showed a higher proportion of weight loss owing to dietary instructions provided by registered dietitians (Figure 3). Based on these results, we are going to advance our study with the aim of re-educating registered dietitians and standardizing interprofessional cooperation systems *. We also aim to identify markers of CKD for its early detection and prevention. In addition, to reduce the rate of new dialysis patients by at least 15% in 5 years, and maintain the resultant rate thereafter, our research unit is going to develop medical care systems to prevent lifestyle-related CKD in collaboration with basic research, society, and clinical medicine.
*1: Standardization: Enabling patients to access standard medical care anywhere, and resolving medical disparities between regions
● Implementation of programs to promote the health of residents of Tsukuba City as one of the regional cooperation projects organized by the city, University of Tsukuba, and Intel Corporation
● Management of the health of patients living in Date City, Fukushima Prefecture, who were affected by the Great East Japan Earthquake
● Verification of the results of strategic research, the publication of evidence supporting these results, and the establishment of favorable CKD-related medical cooperation
(Interviewed on September 10, 2013)