移植失败后的透析:如何应对这个艰巨的任务?
Cem Tanriover1, Sidar Copur1, Carlo Basile2
1Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
Journal of nephrology
|September 7, 2023
概括
移植可以改善生活质量,但长期的移植存活能力不足. 本综述讨论了移植失败后的透析管理,强调了个性化的患者护理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植医学 移植医学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 脏移植是末期脏病的最佳治疗方法,比透析提供更好的存活率和生活质量.
- 尽管取得了进展,但长期合移植的存活率仍然不足于最佳水平,导致越来越多的患者需要在移植后重新启动透析.
- 在移植损失后进行透析的管理对患者和医疗保健团队构成挑战,缺乏具体的临床指南.
研究的目的:
- 提供关于透析在患有代移植衰竭的患者的作用和管理的全面视角.
- 审查当前的理解,并解决在移植不成功后启动和维持透析的复杂性.
- 突出需要量身定制的方法来管理脏移植失败的患者.
主要方法:
- 这是一个叙事综述,综合了关于移植失败和随后透析的现有文献.
- 该审查审查了患者的结果,管理策略,以及对透析后异位移植损失的临床建议.
- 它考虑了影响透析启动和治疗方式选择决策过程的因素.
主要成果:
- 虽然一些研究报告了移植失败后透析患者的死亡率增加,但研究结果并不一致.
- 个性化以患者为中心的护理对于治疗透析后移植失败至关重要.
- 关键决策包括透析启动时间,透析方式的选择,持续的免疫抑制和血管接入规划.
结论:
- 移植失败后透析的有效管理需要个性化的方法,考虑患者特定的因素.
- 需要进一步的研究和明确的指导方针,以优化透治疗失败移植患者的治疗.
- 一个多学科的团队方法是必要的,以支持患者通过移植损失后透析过渡.
相关概念视频
01:16Kidney Transplant III: Nursing Management
39
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
39
01:27Dialysis
353
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
353
01:25Hemodialysis III: Nursing Management
49
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
49
01:26Kidney Transplant II: Surgical Procedure
36
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
36
01:28Kidney Transplant I: Introduction
28
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
28
01:20Acute Kidney Injury V: Interprofessional Care
25
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
25