The role of clinical engineers in dialysis therapy in Japan

Abstract

AbstractTraditionally in Japan, dialysis treatment has been performed primarily by physicians and nurses. However, with the advancement of related medical equipment, such as the development of dialyzers and dialysis monitoring equipment, technical support by technicians has become necessary. Therefore, in 1988, the “Clinical Engineers Act” was enacted and recognized as an official national qualification for technicians to operate these devices, in light of the actual status of these technicians and the fact that further advancement and diversification of medical devices will require their expertise in the future. This is a professional qualification unparalleled anywhere in the world. In dialysis treatment, purification of dialysate and efficient removal of uremic substances are fundamental principles. Clinical engineers have contributed significantly to the elimination of biological and chemical contaminants in the process of production of dialysis water, to the development of high-performance membranes, and to the development and advancement of online HDF, a high-volume fluid replacement method. Furthermore, clinical engineers have been involved in the proposal and development of safe devices to prevent medical accidents that occur during continuous dialysis treatment for many patients. Clinical engineers will continue to contribute to the provision of the best treatment methods, not only in the development and deployment of equipment, but also in remote medicine and the utilization of large-scale data, as they are medical professionals with knowledge of both medicine and engineering. Furthermore, the scope of the profession, which started in the field of hemodialysis, has the potential to expand to include peritoneal dialysis and other modalities of renal replacement therapy.