Fraser Simon D S, Taal Maarten W
aAcademic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire SO16 6YD bDivision of Medical Sciences and Graduate-Entry Medicine, University of Nottingham cDepartment of Renal Medicine, Royal Derby Hospital, Derby, UK.
Curr Opin Nephrol Hypertens. 2016 Nov;25(6):465-472. doi: 10.1097/MNH.0000000000000270.
With ageing populations, the prevalence of multimorbidity is increasing. This review discusses recent developments in the understanding of multimorbidity in the context of chronic kidney disease (CKD). It explores the associated treatment burden and the implications for key outcomes and patient care.
Comorbidity and polypharmacy are common in CKD, even at early stages, and are associated with significant treatment burden. Both 'concordant' and 'discordant' comorbidities have a negative impact on mortality, cardiovascular disease, hospitalisation and length of stay. In addition, quality of life is influenced by many factors beyond CKD, including comorbidities and certain medications. Several factors may reduce treatment burden for people with CKD, though research on this is at an early stage. Although patient activation is desirable to support self-management amongst people with multimorbidity, there are significant challenges that impact patient capacity amongst elderly populations with complex needs.
Comorbidities are common in CKD and have important implications for patients, clinicians and health services.
随着人口老龄化，多种疾病并存的情况日益普遍。本综述讨论了在慢性肾脏病（CKD）背景下对多种疾病并存的最新认识进展。探讨了相关的治疗负担以及对关键结局和患者护理的影响。
合并症和多重用药在CKD中很常见，即使在早期阶段也是如此，并且与显著的治疗负担相关。“一致”和“不一致”的合并症均对死亡率、心血管疾病、住院率和住院时长有负面影响。此外，生活质量受CKD以外的许多因素影响，包括合并症和某些药物。尽管对此的研究尚处于早期阶段，但有几个因素可能会减轻CKD患者的治疗负担。虽然患者积极性对于支持患有多种疾病的患者进行自我管理很有必要，但对于有复杂需求的老年人群体，存在重大挑战影响患者能力。
合并症在CKD中很常见，对患者、临床医生和卫生服务具有重要意义。
