在透析神话和被忽视的基于证据的医学之间,对末期病的保守管理
Francesca K Martino1, Giacomo Novara2, Federico Nalesso1
1Nephrology, Dialysis, Transplantation Unit, Department of Medicine (DIMED), University of Padova, 35124 Padua, Italy.
Journal of clinical medicine
|January 11, 2024
概括
保守管理 (CM) 是老年终末期病 (ESKD) 患者未充分利用的选择. 对于脆弱的老年人,预期寿命短,息治疗可能是最合适的选择.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 抚慰性护理是一种缓解性护理.
背景情况:
- 人口老龄化导致末期病 (ESKD) 的老年患者增加.
- 老年ESKD患者通常很脆弱,有多种并发症,在生存或生活质量方面可能不会从透析中受益.
- 保守管理 (CM) 是透析的潜在替代方案,提供了一种不那么侵入性的方法.
研究的目的:
- 评估保守管理 (CM) 作为终期病 (ESKD) 的老年患者可行的治疗选择.
- 为了突出CM的不足利用,由于误解透析是唯一有效的治疗方法.
- 强调基于患者特定因素的个性化治疗决定的重要性.
主要方法:
- 审查关于老年人ESKD管理的当前文献.
- 在脆弱的老年人群中,透析和保守管理 (CM) 之间的结果比较.
- 分析影响治疗选择的因素,包括并发症,功能状态和社会背景.
主要成果:
- 保守管理 (CM) 可以使老年ESKD患者能够在日常生活中受到最小的干扰的情况下活几个月到几年.
- 透析可能不会改善脆弱,老年ESKD患者的生存率或生活质量.
- 关节功能的利用不足,经常被透析被认为是唯一有效的替代疗法所掩盖.
结论:
- 保守管理 (CM) 和透析都是ESKD的老年患者的有效治疗选择.
- 治疗决策应该是个性化的,考虑并发症,残疾和社会背景.
- 对于预期寿命有限的老年患者来说,息治疗通常是最合适的建议.
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