title: Need for education on the differential diagnosis between chronic glomerulonephritis and nephrosclerosis, and treatment of both conditions to reduce the number of patients requiring hemodialysis in Wakayama.
abstract: OBJECTIVE
  We investigated the present state of, and trends in, hemodialysis therapy in Wakayama, with the aim of identifying present and future problems.
  
  
  METHODS
  We compared the number of patients on maintenance hemodialysis, patients newly commencing hemodialysis each year, and proportion of diseases prompting the initiation of hemodialysis, between Wakayama and all Japan from 2002 to 2009, using the CD-ROM, "An overview of dialysis treatment in Japan," published by the Japanese Society for Dialysis Therapy.
  
  
  RESULTS
  The number of patients on maintenance hemodialysis per head of population was higher in Wakayama than in all Japan throughout the study period. The number of patients newly commencing hemodialysis per head of population was higher in Wakayama than in all Japan from 2002 to 2004, but no significant difference was seen after 2005. The proportion of patients with chronic glomerulonephritis as the causative disease for hemodialysis initiation was higher in Wakayama than in all Japan. However, nephrosclerosis was less common as the causative condition in Wakayama than in all Japan. The proportions of the different causative diseases were similar in all patients on maintenance hemodialysis in Wakayama as in the newly initiated patients. Accordingly, some patients diagnosed with chronic glomerulonephritis might actually have nephrosclerosis, or treatment may be inadequate.
  
  
  CONCLUSIONS
  In order to reduce the number of patients requiring maintenance hemodailysis, it is important to accurately differentiate between chronic glomerulonephritis and nephrosclerosis, and also to treat patients with either disease appropriately.
authors: Division of Nephrology and Blood Purification Medicine, Wakayama Medical University, Japan.
authors: Yuri
authors: Y
authors: Nakashima
authors: Toru
authors: T
authors: Mima
authors: Shigeo
authors: S
authors: Negi
authors: Toshifumi
authors: T
authors: Sakaguchi
authors: Toshihiko
authors: T
authors: Kashii
authors: Yuji
authors: Y
authors: Kita
authors: Ken
authors: K
authors: Kunimoto
authors: Koichi
authors: K
authors: Tatsuta
authors: Masanori
authors: M
authors: Okamoto
authors: Toshihiro
authors: T
authors: Satou
authors: Takashi
authors: T
authors: Shigematsu
mesh_terms: D002908:Chronic Disease; D003937:Diagnosis, Differential; D004501:Education, Medical; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D009400:Nephrosclerosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006435:Renal Dialysis / Q000706:statistics & numerical data