Oppenheimer Federico, García García Manuel, López Alba Thaïs, Campistol José Ma
Servicio de Nefrología, Hospital Clínico de Barcelona, Barcelona.
Nefrologia. 2009;29 Suppl 1:72-7. doi: 10.3265/NEFROLOGIA.2009.29.S.1.5641.EN.FULL.
Patients with stabilized kidney transplant receive optimal management care when there is effective coordination between the transplant centre and the community nephrologist (Evidence level C). A good coordination with regular interactive communication between the transplant centre and community nephrologist is very positive for patients and beneficial to the transplant centre and community nephrologist (Evidence level C). Many of the clinical objectives for management of kidney transplant recipients are similar to those related to chronic kidney disease patients (Evidence level C). A good coordination between the transplant centre and community nephrologist needs organizational requirements and clinical management protocols (Evidence level C).When irreversible renal allograft failure occurs, the community nephrologist must assume the preparation for dialysis as with other patients with advanced chronic kidney disease: choose dialysis methods, create arteriovenous fistulae or place peritoneal catheter and identify dialysis treatment centre. Moreover, the transplant centre and the community nephrologist will jointly decide the best moment to start dialysis or the possibility of preemptive kidney transplant (Evidence level C).
当移植中心与社区肾病专家之间进行有效协作时，肾移植病情稳定的患者就能得到最佳管理护理（证据级别C）。移植中心与社区肾病专家之间通过定期互动交流进行良好协作，对患者非常有利，也有益于移植中心和社区肾病专家（证据级别C）。肾移植受者管理的许多临床目标与慢性肾病患者的相关目标相似（证据级别C）。移植中心与社区肾病专家之间的良好协作需要组织要求和临床管理方案（证据级别C）。当发生不可逆的肾移植失败时，社区肾病专家必须像对待其他晚期慢性肾病患者一样，做好透析准备：选择透析方式、建立动静脉内瘘或置入腹膜导管，并确定透析治疗中心。此外，移植中心和社区肾病专家将共同决定开始透析的最佳时机或进行抢先肾移植的可能性（证据级别C）。
