• Greetings from the President

Greetings from the President


After many years of supporting pharmacists and researchers as a study group, this year we have been officially appointed as an academic research society. Looking back, the Kansai Kidney and Pharmaceuticals Study Group was established at the end of 1999, and in April 2000 we started to offer study meetings five times a year. This small effort soon spread across Japan, and by 2006 affiliated study groups had been established in seven different Japanese prefectures. In November that same year, representatives from the seven study groups gathered in Osaka and established the original Japanese Society of Nephrology and Pharmacotherapy to undertake a wide spectrum of educational and research activities on pharmacotherapy for kidney disease and dialysis as well as to facilitate information exchange and collaboration between physicians, pharmacists, and researchers in the field of kidney disease.

The First Annual Meeting was held in Osaka in November 2007, and there were more than 500 participants at the next three meetings held in Kumatomo, Nagoya, and Tokyo. The Fifth Annual Meeting in Kita-Kyushu drew around 1000 participants, and the Sixth Annual Meeting drew almost 700, indicating just how successful the research meeting has become. After doubling the number of local Society offices to 14 in five years and implementing bold organizational reforms, we lauched the new and improved Japanese Society of Nephrology and Pharmacotherapy in January 2012.

As an academic research society, we will publish multiple peer-reviewed journals (including meeting proceedings) more than three times annually. The end of each issue will contain a table of detailed and most recent "optimal drug administration strategies", including information on the pharmacokinetic parameters needed to establish the appropriate administration. Members can access this original and up-to-datecontent from the Society's website. Also, starting in January 2012, a Certificate of Completion of Nephrology and Pharmacotherapy Training is being issued to those who have successfully completed the training course. We will also publish the Society of Nephrology and Pharmacotherapy Certified/Specialized Pharmacist textbooks.

In August 2013, in conjunction with the Japanese Society of Nephrology and the Japanese Society for Dialysis Therapy, we will launch the first Japanese Society of Nephrology and Pharmacotherapy Specialized/Certified Pharmacist Examination and certify successful applicants as specialized/certified pharmacists. In this new system, applicants who have completed the special training held by the Society are eligible to take this examination. To become a specialized pharmacist, the submission of 30 clinical cases is required.

Today, we see signs that the traditional roles of Japanese pharmacists will change dramatically from supplying, dispensing, and instructing on the administration of drugs. This is in large because the students of the new six-year pharmacy program have just graduated in 2012 and because the notification of "Promotion of Team Medicine through the Cooperation and Collaboration of Medical Staff" issued in April 2010 by the Ministry of Health, Labour and Welfare was made public. The Japanese Society of Hospital Pharmacists provides an explanation of this notification and a number of specific examples on their website. One such example is "Management of abnomal mineral metabolism in patients on maintenance dialysis". In addition to the excellent examples given, there are also many other roles pharmacists can play.

In 2011, there were 23 deaths in a six-month period from bleeding caused by a new renal excretable anticoagulant, and we also watched the "Saitama medication dispensing error incident" unfold before our eyes the same year. In that particular case, the cause of death was unintentional administration of an excessive dose of a renal excretable cholinesterase inhibitor to an elderly patient with decreased renal function. Kidney function thus greatly influences the appropriateness of drugs prescribed. This unfortunate case proved to be a valuable lesson reminding us that it can be life-threatening if patients with decreased renal function are administered the recommended dose of drugs used in therapeutic drug monitoring (TDM) with a high rate of adverse effects, such as renal excretable anti-cancer, anticoagulants, and antiarrhythmic drugs. Such toxic side effects could have been prevented if the pharmacist had checked the prescription, optimized the dosage, and properly instructed the patient to consult a physician as soon as the initial signs of side effects developed.

Unfortunately, adverse events caused by inproper drug therapy happen everyday. My own definition of a pharmacist is "a medical professional who responsibly offers effective, safe, and the most appropriate drug therapy optimized to the individual patient". Our mission is extensive in scope: 1) to ensure the proper use of drugs and prevention of toxic side effects in patients with decreased renal function, 2) to prevent renal function deterioration and cardiovascular complications through proper medication guidance, 3) to provide appropriate drug therapy to dialysis patients with complications, and 4) to prevent drug-induced renal damage caused by nephrotoxic agents and drugs inducing renal ischemia. Although the list goes on, I would like to emphasize the importance of these four points and emphasize the need for preventive measures.

The proper administration of drugs that potentially affect renal function is a huge task, and consequently the four points mentioned above focus heavily on the aspects for which both general and specialized pharmacists must take the initiative to handle appropropriately. Although I have taked about pharmacists up to this point, as I stated earlier, other medical progessionals including physicians and researchers are also Society members. I believe we can all contribute to improving the quality of medical care and the health of the general public by providing effective and safe drug therapy to a broad spectrum of patients, including patients with mild renal impairment, those on dialysis, those having undergone renal transplantation, elderly patients with decreased renal function, and infants with immature renal development. I greatly appreciate your continued support and cooperation in achieving our Society's goals.

Sumio Hirata
President of the Japansese Society of Nephrology and Pharmacotherapy