title: Transition of adolescent and young adult patients with childhood-onset chronic kidney disease from pediatric to adult renal services: a nationwide survey in Japan.
abstract: BACKGROUND
  Transition of adolescent and young adult (AYA) patients with childhood-onset chronic kidney diseases (C-CKD) from pediatric to adult renal services has received increasing attention. However, information on transition of Japanese patients with C-CKD is limited.
  
  
  METHODS
  The Transition Medicine Working Group, in collaboration with the Japanese Society for Nephrology, the Japanese Society for Pediatric Nephrology and the Japanese Society of Pediatric Urology, conducted a retrospective cross-sectional study in 2014 on issues concerning the transition of Japanese patients with C-CKD.
  
  
  RESULTS
  Few institutions in Japan had transition programs and/or transition coordinators for patients with C-CKD. Refusal to transfer by patients or their families, lack of concern about transition and inability to decide on transfer were common reasons for non-transfer of patients still followed by pediatric renal services. Around 25 % of patients who had ended or interrupted follow-up by pediatric renal services presented to adult renal services because of symptoms associated with C-CKD. Patients with various types of childhood-onset nephrourological diseases were transferred from pediatric to adult renal services. IgA nephropathy, minimal change nephrotic syndrome and congenital anomalies of the kidney and urinary tract were the most frequent primary kidney diseases in adult patients with C-CKD.
  
  
  CONCLUSIONS
  These survey results indicate the need for introduction of transitional care for Japanese AYA patients with C-CKD. Consensus guidelines for the optimal clinical management of AYA patients with C-CKD are required to ensure the continuity of care from child to adult renal services.
authors.affiliation: Department of Pediatric Nephrology, Tokyo Women's Medical University, School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. hattori@kc.twmu.ac.jp.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Hattori
authors.affiliation: Division of Nephrology, Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iwano
authors.affiliation: Division for Clinical Trials, Department of Clinical Research, Center for Clinical Research and Development, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Sako
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
authors.affiliation: Department of Nephrology and General Internal Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Pediatric Nephrology, Tokyo Women's Medical University, School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Akioka
authors.affiliation: Department of Pediatrics, Osaka Medical College, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ashida
authors.affiliation: Department of Pediatrics, Division of Medical Science, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Kawasaki
authors.affiliation: Department of Community Medical Supports, Tohoku Medical Megabank Organization, Sendai, Japan.
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Kiyomoto
authors.affiliation: Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Terada
authors.affiliation: Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Daishi
authors.initials: D
authors.lastname: Hirano
authors.affiliation: Department of Pediatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Mikiya
authors.initials: M
authors.lastname: Fujieda
authors.affiliation: Department of Hemovascular Medicine and Artificial Organs, University of Miyazaki, Kochi, Japan.
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
authors.affiliation: Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Masaki
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Seiich
authors.initials: S
authors.lastname: Mastuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D004651:Employment; D006801:Humans; D007564:Japan / Q000453:epidemiology; D009398:Nephrology; D010353:Patient Education as Topic; D010372:Pediatrics; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adolescent and young adult patients; Adult renal services; Childhood-onset chronic kidney disease; Pediatric renal services; Transition