1 Section of Palliative Care and Medical Ethics, Renal-Electrolyte Division, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
2 Division of Nephrology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
J Palliat Med. 2018 Apr;21(4):546-551. doi: 10.1089/jpm.2018.0087.
Many patients with chronic kidney disease (CKD) and end-stage renal disease have unmet palliative care (PC) needs. Physical and emotional symptoms are common. Some, like uremia and fluid overload, improve with dialysis, but the increasing age of patients initiating renal replacement therapy leaves many untreatable comorbidities like dementia and frailty to negatively impact quality of life. Written by nephrologists and PC clinicians, this article will help PC providers to have a richer understanding of kidney disease-related symptom burden, disease trajectory, prognosis, and barriers to hospice enrollment for patients with CKD and end-stage renal disease.
许多患有慢性肾脏病（CKD）和终末期肾病的患者有未满足的姑息治疗（PC）需求。身体和情绪症状很常见。一些症状，如尿毒症和液体超负荷，可以通过透析得到改善，但接受肾脏替代治疗的患者年龄不断增加，导致许多无法治疗的合并症，如痴呆和虚弱，对生活质量产生负面影响。本文由肾脏病学家和姑息治疗临床医生撰写，将帮助姑息治疗提供者更深入地了解与肾脏病相关的症状负担、疾病轨迹、预后以及慢性肾脏病和终末期肾病患者进入临终关怀的障碍。
