Raj Rajesh, Ahuja Kiran D K, Frandsen Mai, Jose Matthew
School of Medicine, University of Tasmania, Launceston, Tasmania, Australia.
School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia.
BMJ Open. 2016 Dec 8;6(12):e013755. doi: 10.1136/bmjopen-2016-013755.
Older adults constitute the largest group of patients on dialysis in most parts of the world. Management of advanced renal disease in the older adult is complex; treatment outcomes and prognosis can be markedly different from younger patients. Clinical teams caring for such patients are often called on to provide information regarding prognosis and outcomes with treatment-particularly, the comparison between having dialysis treatment versus not having dialysis. These discussions can be difficult for clinicians because they have to contend with incomplete or nascent data regarding prognosis and outcomes in this age group. We aim to summarise the currently available information regarding the prognosis and outcomes of advanced renal disease in the older adult by means of a scoping review of the literature. This article discusses our protocol.
This scoping review will be undertaken in accordance with the Joanna Briggs Institute's methodology for scoping reviews. A directed search will look for relevant articles in English (within electronic databases and the grey literature), written between 2000 and 2016, which have studied older patients with advanced renal disease (estimated glomerular filtration rate <30 mL/min/1.73 m). After screening by two independent reviewers, selected articles will be analysed using a data charting tool. Reporting will include descriptions, analysis of themes using qualitative software and display of information using charts.
This scoping review will analyse previously collected data, and so does not require ethical approval. Results will be disseminated through academic journals, conferences and seminars. We anticipate that our summary of the currently available knowledge regarding the older adult with advanced renal disease will be a repository of information for clinicians in the field. We expect to identify areas of study that are suited to systematic reviews. Our findings can also be expected to influence guidelines and clinical practice recommendations in the future.
在世界大部分地区，老年人是接受透析治疗的最大患者群体。老年晚期肾病的管理很复杂；治疗结果和预后可能与年轻患者明显不同。照顾这类患者的临床团队经常被要求提供有关治疗预后和结果的信息，特别是透析治疗与不进行透析的比较。对于临床医生来说，这些讨论可能很困难，因为他们必须应对该年龄组中关于预后和结果的不完整或新出现的数据。我们旨在通过对文献的范围综述来总结目前关于老年晚期肾病预后和结果的可用信息。本文讨论了我们的方案。
本范围综述将按照乔安娜·布里格斯研究所的范围综述方法进行。定向搜索将寻找2000年至2016年期间用英文撰写的相关文章（在电子数据库和灰色文献中），这些文章研究了老年晚期肾病患者（估计肾小球滤过率<30 mL/min/1.73 m²）。经过两名独立评审员的筛选后，将使用数据图表工具对选定的文章进行分析。报告将包括描述、使用定性软件对主题进行分析以及使用图表展示信息。
本范围综述将分析先前收集的数据，因此无需伦理批准。结果将通过学术期刊、会议和研讨会进行传播。我们预计，我们对目前关于老年晚期肾病患者可用知识的总结将成为该领域临床医生的信息库。我们期望确定适合进行系统综述的研究领域。我们的研究结果预计也将在未来影响指南和临床实践建议。
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