• Kyodo

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The Tokyo Metropolitan Government has begun investigating a hospital suspected of suggesting to 149 kidney disease patients since 2013 that they not receive dialysis treatment, resulting in the death of at least one female renal patient and decisions by some 20 others to quit, it was learned Thursday.

The patient in her 40s died about a week after signing a letter of consent to end dialytic treatment, after a doctor at Fussa Hospital in western Tokyo explained to her and her family that the decision may result in death, the sources said.

According to guidelines set in 2014 by the Japanese Society for Dialysis Therapy, the termination of hemodialysis should only be considered in specific cases, including when it is difficult to continue the treatment safely and when the treatment itself could elevate the risk of death.

The doctor told her in August last year she could either continue receiving dialysis or stop it, the sources said. The woman, who had undergone the treatment at a different clinic, went to the public hospital to seek advice on the best course of treatment.

“There is a possibility that the patient was not in a terminal phase, in which case the medics should not have proposed stopping her dialysis treatment,” said Kazuyoshi Okada, a doctor and member of the investigation committee set up by the Japanese Society for Dialysis Therapy to probe the woman’s case.

A further investigation into the matter has been launched by the Tokyo Metropolitan Government. According to a media report, two other patients at the hospital — men in their 30s and 50s — also chose to have their dialysis treatment stopped, and the older man later died.

“We are checking whether the hospital is managed and operated appropriately,” an official at the metropolitan government said.

A hospital spokesman declined to comment on the matter.

Yoshiaki Takemoto, another member of the Japanese Society for Dialysis Therapy, said that a doctor would probably only face a situation where a patient has to withdraw from hemodialysis about once a year. “I have never been in such a situation,” said Takemoto, a professor of urology at Osaka City University.

Hemodialysis is used to treat patients with declining kidney function. In general, patients use dialysis machines about three times a week to remove waste from blood. Each treatment takes three to five hours.

The number of people who receive hemodialysis has been increasing in Japan and topped 300,000 for the first time in late 2011, according to the Japanese Society for Dialysis Therapy.

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