Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
Adv Chronic Kidney Dis. 2014 Jul;21(4):360-4. doi: 10.1053/j.ackd.2014.02.013.
As the incidence of CKD increases, so will the ESRD population. Pre-ESRD care, including early referral to nephrology and patient education, enables patients and providers working together to determine which therapy modality is best suited for their individualized needs: conservative therapy, kidney transplant, hemodialysis, or peritoneal dialysis. Differentiating the therapy modality should be based on many factors and not solely based on outcome data. Acknowledging that there is no "one-size-fits-all" therapy modality allows the patient and the interdisciplinary team to ensure that the appropriate access is chosen at the appropriate time. Lastly, the timing of initiation is paramount for improving patient outcomes, including less central venous catheter placement in incident hemodialysis and more planned arteriovenous accesses, improved quality of life, less hospitalization time, and reduced costs.
随着慢性肾脏病（CKD）发病率的上升，终末期肾病（ESRD）患者人数也将增加。ESRD 前的护理，包括早期转至肾病科和患者教育，使患者和医务人员能够共同合作，确定哪种治疗方式最适合他们的个体需求：保守治疗、肾移植、血液透析或腹膜透析。区分治疗方式应基于许多因素，而不仅仅是基于结果数据。承认没有“一刀切”的治疗方式，这使得患者和跨学科团队能够确保在适当的时间选择适当的通路。最后，开始治疗的时机对于改善患者的预后至关重要，包括在新发生的血液透析中减少中心静脉导管的放置，更多地进行计划动静脉通路，提高生活质量，减少住院时间和降低成本。
