Questionnaire survey of the current situation and complications of dialysis patients undergoing more tham 10 years' dialysis in Hyogo Prefecture

We conducted a questionnaire survey of chronic dialysis patients in Hyogo Prefecture who had been on dialysis for 10 or more years. Our survey covered 233 patients at 32 institutions. There were more rates (138) than females (95), a trend which was significant among long-term dialysis patients. Their ages ranged from 21 to 75 years (average 47.1±10.0). A majority of the patients were outpatients (96.1%) and were treated with hemodialysis (99.1%) using an arteriovenous fistula (89.2%), bicarbonate dialysate (79.2%), reverse osmosis fluid (85.3%), and a hollw fiber dialyzer (99.1%). Most of the patients were treated three times a week for a total of 15 hours. The urine volume was zero in more than half of the patients who were treated two time a week, but overall they were considered to be sufficiently managed. The causative disease in most patients was chronic glomerulonephritis, and there were markedly fewer hemodialysys patients with diabetic nephropathy than those who started hemodialysis therapy in recent years. Of the patients surveyed, 42.1% were employed, 20.6% were housewives, and 32.2% were unemployed. The average values of the various examinations performed around December of 1985 indicated that the patients were being well managed, but there were some extremely abnormal values in individual cases. Of these values, significantly higher hematocrit levels, lower cardiothoracic ratios, and higher creatinine levels were seen in males than in females, and in employed patients than in housewives and unemployed patients. Of the patients surveyed, 85.0% had experienced at least one major complication from the time they first began dialysis until December 1985. Of these complications, renal osteodystrophy (ROD), heart failure, hepatitis, hypertension, infectious diseases, carpal tunnel syndrome (CTS), and hypotension were relatively more common. With the duration of dialysis, the number of patients with ROD, CTS, hypotension, arrhythmias, and/or ischemic heart disease tended to increase, and that with heart failure, pericarditis, and/or hypertension tended to decrease. The increase in ROD and CTS in recent years was particularly marked, and both complications were particularly common among patients with dialysis histories of more than 15 years.