Perioperative Risks and Management Strategies for Chronic Kidney Disease and Dialysis Patients Using the National Clinical Database

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K17750
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53040:Nephrology-related
• Research Institution: The University of Tokyo (2022-2023); Keio University (2019-2021)
• Principal Investigator: Yamamoto Hiroyuki 東京大学, 医学部附属病院, 特任准教授 (80528852)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 腎機能 / 術後アウトカム / 透析療法 / 診療報酬データベース / レジストリ / 大規模データベース

Outline of Final Research Achievements

In this research project, we conducted an observational study using large scale data and statistical methods with high affinity to the National Clinical Database. Utilizing the surgical database and reimbursement database from the National Clinical Database, the following issues were resolved. (1) The continuous association between preoperative renal function (eGFR) and surgical risk. (2) Association between preoperative and perioperative dialysis therapy and postoperative outcomes.
As a result of this research project, the association between the degree of renal dysfunction and surgical risk has been visualized in more detail. The ability to predict and address this relationship may lead to more optimal perioperative treatment choices for renal failure and dialysis patients. This information is considered important for the practice of evidence-based medicine.

Free Research Field

臨床疫学

Academic Significance and Societal Importance of the Research Achievements

本研究課題の成果として、腎機能障害の程度と手術リスクの関連が、大規模データを用いて、より詳細・明確にに可視化されたことである。本研究課題で得られた成果を元として、臨床現場においても様々な程度の腎機能低下症例に対して、術後の状態の予測および対処が可能となることが考えられる。腎不全や透析患者に対する、周術期のより最適な治療選択が可能と考えられる。これらの情報は、根拠に基づいた医療の実践の上で重要な情報と考えられる。この領域のさらなる進歩のための重要な一歩となったと考えられる。