Saitama Medical University, Japan
Title: Predialysis care for elderly subjects with Chronic kidney disease
Hiromichi Suzuki has completed his MD at the age of 27 years from School of Medicine, Hokkaido University and Postdoctoral studies from School of Medicine, Keio University. Currently, he is the Professor of Department of Nephrology, Saitama Medical University and the Director of Community Health Science Center, Saitama Medical University. He has published more than 400 papers and has been serving as an editorial board member of several repute journals.
Chronic kidney disease (CKD) and its complications, which involve most organ systems, can be prevented. Cardiovascular diseases and neoplasms are the two major fatal complications. Although it is important to prevent these two, there have been few discussions, and awareness and use of accurate methods are needed to enable timely diagnosis. Based on our more than 10 years experience in a long term care of predialysis patients with CKD, simple and accurate tests will be presented. A single center, retrospective cohort study was performed that included 553 patients (female/male; 179/343; 71 + 4 years old) in stages 4 and 5 CKD (estimated GFR 15 + 6 ml/min/1.73 m2) were treated in the kidney disease center from 2001 to 2009. 11 patients had fatal myocardial infarctions, 6 patients had non fatal cerebrovascular infarction and 19 patients had neoplasms. Based on these data, we started to search for a method for early detection of cardiovascular diseases and neoplasms. For cardiovascular diseases, left ventricular hypertrophy found in echocardiography was associated with progression to dialysis but not with early detection of catastrophic cardiovascular diseases. On the other hand, occult blood in stool samples helped to find polyploid lesions with malignancy in the large intestine.
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