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Specific targets include 1.4 for single-pool Kt\/V (spKt\/V) with a minimum dose of 1.2, minimum dialysis session length of 4 hours, minimum blood flow rate (BFR) of 200 mL\/min, fluid removal rate no more than 15 mL\/kg\/hr, and hemodiafiltration (HDF) therapy for certain identified symptoms. We evaluated the effect of these guidelines on actual practice in the years spanning 2005 \u2013 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analyses were carried out to describe trends in the above HD prescription practices from December 2005 to April 2013 (<jats:italic>before guideline publication<\/jats:italic>) to August 2018 based on prevalent patient cross-sections from approximately 60 randomly selected HD facilities participating in the Japan Dialysis Outcomes and Practice Patterns Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From April 2006 to August 2017 continual rises occurred in mean spKt\/V (from 1.35 to 1.49), and percent of patients having spKt\/V&gt;1.2 (71% to 85%). Mean BFR increased with time from 198.3 mL\/min (April 2006) to 218.4 mL\/min (August 2017) , along with percent of patients with BFR &gt;200 ml\/min (65% to 85%). HDF use increased slightly from 6% (April 2006 and August 2009) to 8% by April 2013, but increased greatly thereafter to 23% by August 2017. In contrast, mean HD treatment time showed little change from 2006-2017, whereas mean UFR declined from 11.3 in 2006 to 8.4 mL\/Kg\/hour in 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>From 2006 \u2013 2018 Japanese HD patients experienced marked improvement in reaching the spKt\/V target specified by the 2013 JSDT guidelines. This may have been due to moderate increase in mean BFR even though mean HD session length did not change much. In addition, HDF use increased dramatically in this time period. Other HD delivery changes during this time, such as increased use of super high flux dialyzers, also merit study. While we cannot definitively conclude a causal relationship between the publication of the guidelines and the subsequent practice changes in Japan, those changes moved practice closer to the recommendations of the guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12882-021-02543-3","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T14:52:04Z","timestamp":1634223124000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Changes in practice patterns in Japan from before to after JSDT 2013 guidelines on hemodialysis prescriptions: results from the JDOPPS"],"prefix":"10.1186","volume":"22","author":[{"given":"Tadashi","family":"Tomo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Larkina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayumi","family":"Shintani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonari","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce M.","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Bieber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Henn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald L.","family":"Pisoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"2543_CR1","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1038\/ki.1985.160","volume":"28","author":"FA Gotch","year":"1985","unstructured":"Gotch FA, Sargent JA. 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Study coordinators at each study facility obtained informed consent from all randomly selected patients. All methods were carried out in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Brian Bieber, Lisa Henn, and Ronald L. Pisoni are employees of Arbor Research Collaborative for Health which administers the DOPPS. Bruce Robinson is an employee of Arbor Research Collaborative for Health, which administers the DOPPS Program. Dr Robinson has received consultancy fees or travel reimbursement from AstraZeneca, GlaxoSmithKline, and Kyowa Kirin Co., all paid directly to his institution of employment. Ayumi Shintani, Maria Larkina, Tomonari Ogawa,and Tadashi Tomo have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"339"}}