Department of Pediatric Nephrology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Acta Paediatr. 2018 Mar;107(3):403-407. doi: 10.1111/apa.14182. Epub 2017 Dec 22.
Paediatric palliative care is no longer restricted to patients with cancer and has been extended to patients with other chronic conditions, such as cystic fibrosis or neuromuscular disorders. This review focused on the current state of palliative care for children and adolescents with chronic kidney disease (CKD). We assessed the literature on CKD published up to August 2017. All the papers, except one from 1996, were published this century. This review discusses the role that palliative care plays in the process of decision-making and explores the possibilities of implementing palliative care into the routine therapy of affected patients and providing support for their families. Offering early palliative care as an integral part of the kidney, supportive care provided by the nephrology care team is both necessary and feasible for patients with CKD. As a minimum, a specialised palliative care team should be involved in patients with multiple comorbidities, in conservative treatment scenarios and in acute life-threatening complications. Further studies and guidelines are required to improve the care of patients with CKD and their families.
Supportive palliative care should be implemented into the routine care of patients with life-limiting kidney disease.
小儿姑息治疗不再局限于癌症患者，已扩展到患有其他慢性疾病（如囊性纤维化或神经肌肉疾病）的患者。本综述重点介绍了目前患有慢性肾脏病（CKD）的儿童和青少年姑息治疗的现状。我们评估了截至 2017 年 8 月发表的关于 CKD 的文献。除了一篇发表于 1996 年的论文外，所有论文均发表于本世纪。本综述讨论了姑息治疗在决策过程中的作用，并探讨了将姑息治疗纳入受影响患者常规治疗和为其家庭提供支持的可能性。为终末期肾脏病患者提供早期姑息治疗作为肾脏支持治疗的一个组成部分，由肾脏病护理团队提供姑息治疗不仅是必要的，而且是可行的。作为最低要求，应让专门的姑息治疗团队参与多合并症患者、保守治疗方案和危及生命的急性并发症的治疗。需要进一步的研究和指南来改善患有 CKD 的患者及其家庭的护理。
应将姑息支持治疗纳入生命末期肾脏病患者的常规治疗中。
