Elucidating the prognostic benefit of extended-hours hemodialysis to overcome MIA syndrome.

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K17277
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53040:Nephrology-related
• Research Institution: Nagoya University
• Principal Investigator: Imaizumi Takahiro 名古屋大学, 医学部附属病院, 特任助教 (40867769)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 長時間透析療法 / MIA症候群 / CKD-MBD / 尿毒素 / 体組成分析 / メタボローム解析 / Calciprotein particle

Outline of Final Research Achievements

To reveal how extended-hours hemodialysis overcomes malnutrition and prevents the progression of arteriosclerosis, we examined the trajectory of body composition parameters, metabolome analysis, which is a comprehensive metabolite measurement, and calciprotein particle (CPP), which is considered to be a causative agent of arteriosclerosis. Muscle mass was well maintained in patients on extended-hours hemodialysis. Metabolome analysis showed higher amino acid concentrations in patients on extended-hours hemodialysis, while higher uremic toxin concentrations in patients on conventional dialysis. Patients on extended-hours hemodialysis also had lower CPP concentrations, and the increase in CPP concentration relative to serum phosphorus levels was slower than in patients on conventional dialysis. This study showed that extending dialysis time improves nutritional status, removes uremic toxins, and decreases factors that promote atherosclerosis.

Free Research Field

腎臓内科学

Academic Significance and Societal Importance of the Research Achievements

我々は過去に、長時間透析療法の予後改善効果が特に高齢透析患者により大きいことを示していた。そして今回、そのメカニズムの一旦を解明することができた。すなわち厳しい食事制限の緩和により食事摂取の増加がもたらすアミノ酸濃度の上昇と、透析時間延伸による尿毒素や動脈硬化促進物質の減少効果が示され、長時間透析に対する客観的なデータを示すことができた。ますます高齢化が進む透析医療にとり、合併症が少ない快適な透析療法を提供することで、従来透析法の継続が困難であった透析患者に有効な選択肢を提示し、患者の幸福度を高めることにつながるものと期待する。