Motoshi Hattori1, Masayuki Iwano2, Mayumi Sako3, Masataka Honda4, Hirokazu Okada5, Yuko Akioka6, Akira Ashida7, Yukihiko Kawasaki8, Hideyasu Kiyomoto9, Yoshio Terada10, Daishi Hirano11, Mikiya Fujieda12, Shouichi Fujimoto13, Takao Masaki14, Shoichi Maruyama15, Seiich Mastuo15. 1. 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. 2. Division of Nephrology, Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan. 3. Division for Clinical Trials, Department of Clinical Research, Center for Clinical Research and Development, National Center for Child Health and Development, Tokyo, Japan. 4. Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 5. Department of Nephrology and General Internal Medicine, Saitama Medical University, Saitama, Japan. 6. Department of Pediatric Nephrology, Tokyo Women's Medical University, School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. 7. Department of Pediatrics, Osaka Medical College, Osaka, Japan. 8. Department of Pediatrics, Division of Medical Science, Fukushima Medical University School of Medicine, Fukushima, Japan. 9. Department of Community Medical Supports, Tohoku Medical Megabank Organization, Sendai, Japan. 10. Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi, Japan. 11. Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan. 12. Department of Pediatrics, Kochi Medical School, Kochi, Japan. 13. Department of Hemovascular Medicine and Artificial Organs, University of Miyazaki, Kochi, Japan. 14. Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan. 15. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, 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. CONCLUSION: 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.
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. CONCLUSION: 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.
Entities:
Keywords:
Adolescent and young adult patients; Adult renal services; Childhood-onset chronic kidney disease; Pediatric renal services; Transition
Authors: Alan R Watson; Paul N Harden; Maria E Ferris; Peter G Kerr; John D Mahan; Maher Fouad Ramzy Journal: Kidney Int Date: 2011-08-10 Impact factor: 10.612