Presidential Address upon Reappointment

Tadao Akizawa
Division of Nephrology, Department of Medicine,
Showa University School of Medicine

 In June 2010, at the 55th Annual Meeting of the Japanese Society for Dialysis Therapy (JSDT) held in Kobe, I was reappointed as the Society President of JSDT. With plenty of new issues emerging in the management of end-stage renal disease including dialysis medicine during the past 2 years after my initial appointment as the Society President of JSDT, our future is still unpredictable. I am determined to continue making every effort to solve such problems, improve dialysis medicine, and further develop JSDT in close collaboration with board directors, auditors, and councilors.

 Upon starting my last term, I addressed the following issues. I will continue addressing these issues and strive to complete the still-unachieved tasks and solve the problems:

 1. Organizational reform: In accordance with the reform of public service corporations, JSDT became a special civil code corporation in December 1, 2008, and is obliged to apply for authorization as either a general or public interest incorporated association before November 30, 2013. With our draft plan for the new corporation's articles of association and bylaws approved by this year's council and general meetings, we have mostly established the framework of the new corporation. However, our decision to become a general or public interest incorporated association was postponed to this term, because we could not reach an agreement on the type of public services provided by the new corporation. During this term, we shall carefully examine this issue while eyeing the actions of other academic societies, and prepare to make an effective proposal on applying for the new form of corporation at the next general meeting.

 2. Enhanced academic activity: JSDT, an academic institution committed to the development of research and promotion of knowledge on dialysis and related medicine, aims to improve and promote academic activities in the field. During the last term, we realized many achievements, such as making an accurate survey of the number of patients on peritoneal dialysis, encouraging JSDT members to conduct publicly-funded research using the statistical data of JSDT, announcing and creating new guidelines for medical management, and revising the existing guidelines. Also, the academic achievements of JSDT have come to be widely applied in national public medicine for dialysis, such as seen in the adoption of the criteria defined by JSDT on reimbursement for ensuring the quality of water in dialysates and the criteria for approving drugs for kidney and dialysis patients, as well as the adoption, with some modifications, of the proposal made by JSDT on the approval issue regarding on-line HDF machines.  We will strive to further improve Japan's globally-recognized dialysis medicine as well as to improve the prognosis and quality of life (QOL) of dialysis patients in close collaboration with other related academic societies and their members.

 3. Human resource development: To reverse the declining number of young clinicians, researchers, and co-medical workers who wish to become specialists in dialysis medicine, substantial measures will be required. We also need to recruit many physicians and co-medical staff to improve the working environment in the field of dialysis medicine, often viewed as a risky and difficult job under poor conditions. If female physicians and medical co-workers, who cannot work full-time for reasons such as marriage, pregnancy, childbirth, and child care, work in the dialysis unit during their available time, they can maintain their medical skills and knowledge while significantly supporting dialysis therapy. From a gender equality perspective, it is important to establish such a system for supporting female workers, return to work. Regarding the training of medical specialists, many problems have been pointed out. While there are not enough facilities authorized by JSDT and related educational facilities meeting the requirement set by the Japanese Board of Medical Specialties, regional disparities are also prominent. It is important to reform the educational system (board-certified medical specialist system) so that we can effectively train medical specialists in all regions of Japan. We must also make efforts to recruit residents into the field of dialysis medicine. It is also our duty to certify co-medical workers, who support the medical teamwork in dialysis treatment, as specialists, and facilitate their training.

 4. Contribution to public health: With regard to implementing measures against chronic kidney disease, a major national issue, JSDT has been involved in the activities of the Japan Association of Chronic Kidney Disease Initiative (J-CKDI) as a core member and has made substantial progress. However, the number of dialysis patients, including those with acute kidney injury, is steadily increasing. We hope to improve the prognosis of dialysis patients and promote their health by addressing the early detection, prevention, treatment, and management of chronic kidney disease and conducting promotional activities regarding kidney transplantation, which, along with dialysis, is an important means to tackle chronic kidney disease. 

 5. International activities: We will conduct academic activities that will contribute to the development of kidney failure treatment and improvement of dialysis patient prognosis at a global level by continuing our efforts to present globally-recognized research achievements made in Japan. In 2010, we hosted the Nexus Symposium of the International Society of Nephrology (ISN) in cooperation with the Japanese Society of Nephrology (JSN), and were evaluated highly for both academic achievements and the educational training of young researchers. We also sent a delegation to the Acute Kidney Injury Network (AKIN) summit Work-shop and participated in the development of international diagnostic criteria and management. In this term, for JSDT to achieve even higher international recognition, we will undertake a wider range of efforts in international cooperation, including the education and training of people who will treat renal failure in developing countries.

 6. Others: Our website should provide both information about JSDT and a place of communication among JSDT members. We would like to newly build members-only pages to use our website more effectively. We will also start applying the new regulations regarding conflicts of interest. We also plan to have the ethical committee review our clinical studies.

 Due to the tireless efforts of our predecessors, JSDT has made significant progress. At the same time, this means that JSDT is expected to continue high-level achievements and shoulder an increasingly greater responsibility in society. To meet such social demands and responsibilities and further develop as a globally-recognized academic society, we would appreciate the continuing support and assistance of all JSDT members.

July 2010