199280 Increasing incidence of dialysis among the elderly in Japan: An analysis based on cohort vs. census incidence

Tuesday, November 10, 2009: 2:55 PM

Etsuji Okamoto, MD, MPH , Department of Management Sciences, National Institute of Public Health, Wako city, Japan
[Background] Japan has the world-highest prevalence of dialysis with one out of 464 people are on dialysis (cf. US: 1/1000). The number of dialysis patients is growing due not only to population ageing but also to the increasing “incidence” among the elderly.

[Methods] From the statistics published by Japan Society for Dialysis Therapy, age-sex-specific incidence per 100,000 population were compared between 2002 and 2007. Comparison was made between the cohort incidence and census (cross-sectional) incidence for five-years age groups. The cohort of 65-69 years old in 2002 will be 70-74 yo in 2007. If their incidence in 70-74 yo in 2007 is lower than the incidence for the age group of 70-74 yo in 2002, it can be inferred that their incidence was lowered due to prevention. Otherwise, the cohort of 65-69 yo in 2002 showed a deteriorated incidence in the following five years.

[Results] Cohort incidence was lower than census incidence for women in cohorts younger 75 years old in 2002 but higher for cohorts of 75 years or older. For men, cohort incidence was higher than census incidence in cohorts of 40-44, 50-54 and 65-84 yo in 2002. The male cohort of 70-74 yo had the incidence of 114.3 per 100,000 in 2002 and 143.4 in 2007 when they became 75-79 yo. This figure was higher than 126.8 of 75-79 yo in 2002.

[Conclusions] Incidence of dialysis is increasing among the elderly in Japan particularly for men suggesting urgent preventive measures against kidney failures.

Learning Objectives:
Describe a high and increasing prevalence of dialysis among Japanese elderly Explain the cause of increasing incidence of chronic kidney disease among them Evaluate the future predictions and economic consequences without effective counter measures

Keywords: Diabetes, Disease Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Okamoto is currently serving as a researcher of the National Institute of Public Health, a research training are of the Ministry of Health, Labour & Welfare of Japanese government. His research interest is in the field of health economics, gerontology and disease management. He is currently involved in the disease management program for the elderly aiming at management of diabetes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.