Discipline of Nephrology, Faculdade de Medicina, Universidade de São Paulo.
Clinics (Sao Paulo). 2011;66(2):245-50. doi: 10.1590/s1807-59322011000200011.
Patients with chronic kidney disease who receive early nephrology care have a better prognosis with maintenance dialysis. We aimed to determine whether early referral to a nephrologist can also improve the psychological burden of having chronic kidney disease.
Thirty-nine patients with chronic kidney disease that required hemodialysis were studied: 19 had a $ 6-month history of nephrology care (Group1), and 20 had never received any prior nephrology care (Group2). All patients participated in a semi-structured interview that addressed their perceived knowledge and psychological aspects related to CKD and hemodialysis. Demographic and laboratory data as well as socioeconomic status were evaluated.
In both groups, most of the patients were of low socioeconomic status. Group 1 had significantly better laboratory parameters (p<0.05). The patients' answers to the questions showed no differences between the groups: 63% of Group 1 and 55% of Group 2 reported that they had no prior knowledge about dialysis; 58% and 40%, respectively, reported that they ''don't completely understand what the doctor says''; and 74% and 85%, respectively, believed that their ''kidneys would work again''.
Pre-dialysis nephrology care improves the clinical conditions of the patients with chronic kidney disease but is insufficient for minimizing other aspects of having chronic kidney disease.
接受早期肾脏病护理的慢性肾脏病患者在维持透析时预后更好。我们旨在确定早期转介给肾脏病专家是否也能减轻慢性肾脏病患者的心理负担。
研究了 39 名需要血液透析的慢性肾脏病患者:19 名患者有 6 个月的肾脏病护理史(第 1 组),20 名患者从未接受过任何肾脏病护理(第 2 组)。所有患者均参加了半结构化访谈,内容涉及他们对慢性肾脏病和血液透析的认知和心理方面。评估了人口统计学和实验室数据以及社会经济地位。
两组患者的社会经济地位均较低。第 1 组的实验室参数明显更好(p<0.05)。两组患者对问题的回答没有差异:第 1 组 63%的患者表示他们对透析一无所知;第 1 组和第 2 组分别有 58%和 40%的患者表示他们“不完全理解医生的话”;第 1 组和第 2 组分别有 74%和 85%的患者认为他们的“肾脏会再次工作”。
透析前肾脏病护理可改善慢性肾脏病患者的临床状况,但不足以最大限度地减少其他方面的慢性肾脏病。