Kutner Nancy G
Department of Rehabilitation Medicine, Emory University, CRM-1441 Clifton Rd. NE, Atlanta, GA, 30322, USA.
Int Urol Nephrol. 2008;40(4):1151-8. doi: 10.1007/s11255-008-9469-x. Epub 2008 Sep 12.
Osteoporosis, falls, sleep difficulty, cognitive impairment, and depressed mood are major clinical concerns in the geriatric population that are physiologically and psychologically based and are often interrelated. All of these issues have implications for patients' daily functioning and quality of life (QOL). This review synthesizes recent evidence about these prominent issues in geriatric care and related implications for care of older patients with chronic kidney disease (CKD). Recent evidence about pre-dialysis and dialysis treatment strategies that may help to optimize management of older patients is also considered. Although elderly patients often report better psychosocial adjustment to dialysis than do younger patients, physical functioning and cognitive functioning losses challenge the QOL of many elderly persons. Early management of CKD and attention to anemia, consideration of the benefits of peritoneal dialysis compared with hemodialysis, and inclusion of some form of exercise or regular physical activity in routine care provide key opportunities to enhance the functioning and well-being of older patients.
骨质疏松症、跌倒、睡眠困难、认知障碍和情绪低落是老年人群主要的临床关注点，这些问题基于生理和心理因素，且往往相互关联。所有这些问题都会影响患者的日常功能和生活质量（QOL）。本综述综合了有关老年护理中这些突出问题的最新证据，以及对老年慢性肾脏病（CKD）患者护理的相关影响。还考虑了有关可能有助于优化老年患者管理的透析前和透析治疗策略的最新证据。尽管老年患者通常比年轻患者报告对透析有更好的心理社会适应能力，但身体功能和认知功能的丧失对许多老年人的生活质量构成挑战。CKD的早期管理以及对贫血的关注、考虑腹膜透析与血液透析相比的益处，以及在常规护理中纳入某种形式的运动或定期体育活动，为提高老年患者的功能和健康状况提供了关键机会。
