Alston Helen, Burns Aine
Centre for Nephrology, Royal Free Hospitals NHS Foundation Trust, Pond Street, London NW3 2QG, UK.
Healthcare (Basel). 2015 Oct 30;3(4):1075-85. doi: 10.3390/healthcare3041075.
There has been a significant increase in the number of frail older patients diagnosed with advanced chronic kidney disease (CKD) over the past thirty years. These elderly patients have high levels of comorbidity, and as a consequence the face of renal medicine is changing-There is an increasing need to focus on traditionally geriatric areas of expertise such as falls prevention and rehabilitation, and to shift our emphasis onto improving patient well-being rather than longevity. Over the past decade, many nephrologists have found that they are already acting as de facto "amateur geriatricians". This denies patients both the benefits of specialist geriatric assessment, and equally importantly denies them access to the wider geriatric multidisciplinary team. This article describes the prevalence and underlying causes of the so-called "Geriatric Giants" in patients with advanced CKD, and discusses possible improvements in care that closer working with geriatricians could bring.
在过去三十年里，被诊断为晚期慢性肾脏病（CKD）的体弱老年患者数量显著增加。这些老年患者存在高度的共病情况，因此肾脏病医学的面貌正在发生变化——越来越需要关注传统老年医学专业领域，如预防跌倒和康复，并将重点转向改善患者的幸福感而非延长寿命。在过去十年中，许多肾脏病医生发现他们已经在实际充当“业余老年病医生”。这既剥夺了患者接受专科老年医学评估的益处，同样重要的是，也使他们无法接触更广泛的老年医学多学科团队。本文描述了晚期CKD患者中所谓“老年巨人”的患病率及潜在原因，并讨论了与老年病医生更密切合作可能带来的护理改善。
