Department of Medicine, Duke University Medical Center, Durham, NC 27705-3860, USA.
Adv Chronic Kidney Dis. 2010 Jul;17(4):368-77. doi: 10.1053/j.ackd.2010.03.004.
Chronic kidney disease (CKD) has increasingly become a "geriatric" disease, with a dramatic rise in incidence in the aging population. Patients aged >75 years have become the fastest growing population initiating dialysis. These patients have increased comorbid diseases and functional limitations which affect mortality and quality of life. This review describes the challenges of dialysis initiation and considerations for management of the elderly subpopulation. There is a need for an integrative approach to care, which addresses management issues, health-related quality of life, and timely discussion of goals of care and end-of-life issues. This comprehensive approach to patient care involves the integration of nephrology, geriatric, and palliative medicine practices.
慢性肾脏病（CKD）日益成为一种“老年病”，在老年人群体中发病率急剧上升。年龄>75 岁的患者已成为开始透析治疗的增长最快的人群。这些患者合并症和功能障碍增多，影响死亡率和生活质量。本文综述了透析起始的挑战以及老年亚群管理的注意事项。需要采取综合方法进行治疗，既要解决管理问题，又要关注与健康相关的生活质量，还要及时讨论治疗目标和临终问题。这种综合的患者护理方法涉及肾脏病学、老年病学和姑息医学实践的整合。
