The Current Status and Future of Peritoneal Dialysis in Japan.

Background: Recent reports have outlined the present conditions and future prospects of Japanese patients on dialysis. Japan currently has the most rapidly aging population in the world and its dialysis population is also aging rapidly.

Summary: Patients on dialysis in Japan have an extremely good prognosis, probably because of the national health insurance system with efficient introduction of patients to dialysis, creation of a good arteriovenous shunt, an adequate patient education system, management by skilled medical, nursing, and technical staff, and good hygiene. However, although many patients are receiving hemodialysis in Japanese facilities, fewer patients are receiving peritoneal dialysis (PD) or undergoing transplantation. PD is home based, and so offers a high degree of freedom and patient satisfaction, particularly for the elderly. The government is aware of the progress made in the fields of PD and transplantation, and in 2018 revised the reimbursement policy for fees for medical service in accordance with the goal of implementing an "integrated community-based health care system." Key Message: PD is an option for elderly patients and should be considered a strategy for management of renal disease in Japan's super-aging society.