Bennett Lesley
Oxford Kidney Unit, Oxford University Hospitals NHS Trust, Oxford, UK.
J Ren Care. 2013 Jun;39(2):108-17. doi: 10.1111/j.1755-6686.2013.12010.x.
A common complication of chronic kidney disease (CKD) is anaemia; how well this is treated may influence a patient’s independence. The use and the time-consuming nature of intravenous (IV) iron therapies can impose considerable challenges for patients. Time spent receiving and travelling to receive IV iron treatment can impact a patient’s feelings of independence. By recommending increased prescription of IV iron and minimising erythropoiesis-stimulating agent use, the recent Kidney Disease: Improving Global Outcomes (KDIGO) Guideline on anaemia in CKD may compound this situation by increasing the number of hospital visits for therapy.
To assess the potential influence of the KDIGO Guideline on patient independence, this review explores factors that can impact the independence of a person with CKD and proposes how these potential issues may be addressed in the light of this new set of guidelines.
Although the KDIGO Guideline has the potential to reduce patient independence, by acknowledging the needs of the individual early on and employing a multi-disciplinary approach, a balance can be found between utilising the most recent guidelines and meeting the needs of the individual to ensure their on-going independence.
慢性肾脏病(CKD)的常见并发症是贫血;贫血的治疗效果可能会影响患者的独立性。静脉注射铁剂疗法的使用及其耗时性会给患者带来相当大的挑战。接受静脉注射铁剂治疗以及前往治疗地点所花费的时间会影响患者的独立感。通过推荐增加静脉注射铁剂的处方量并尽量减少促红细胞生成素的使用,最近发布的《改善全球肾脏病预后组织(KDIGO)慢性肾脏病贫血指南》可能会因增加治疗所需的医院就诊次数而使这种情况变得更糟。
为评估KDIGO指南对患者独立性的潜在影响,本综述探讨了可能影响CKD患者独立性的因素,并根据这一新的指南集提出了如何解决这些潜在问题。
尽管KDIGO指南有可能降低患者的独立性,但通过尽早认识到个体需求并采用多学科方法,可以在遵循最新指南和满足个体需求之间找到平衡,以确保他们持续保持独立。