Ahmed Faheemuddin Azher, Catic Angela Georgia
OSF Saint Anthony Medical Center, 5666 E State St, Rockford, IL 61108, USA.
Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
J Clin Med. 2018 Dec 20;8(1):5. doi: 10.3390/jcm8010005.
Compared to younger individuals, the prevalence of end-stage renal disease (ESRD) in elders is notably higher. While renal replacement therapy, usually with hemodialysis, is accepted therapy in younger patients with ESRD, decisions regarding the treatment of advanced kidney disease in the elderly population are more complex, secondary to the physiologic changes of aging, concurrent geriatric syndromes, and varying goals of care. Evaluation for possible initiation of dialysis in geriatric patients should be multidisciplinary in nature and patient-focused, including a consideration of physical, cognitive, and social function. If renal replacement therapy is not pursued, optimization of medical management or symptom management needs to be the goal of care.
与年轻人相比，老年人终末期肾病（ESRD）的患病率明显更高。虽然肾替代治疗（通常是血液透析）是年轻ESRD患者公认的治疗方法，但由于衰老的生理变化、并发的老年综合征以及不同的护理目标，老年人群晚期肾病治疗的决策更为复杂。老年患者透析启动可能性的评估本质上应是多学科的且以患者为中心，包括对身体、认知和社会功能的考量。如果不进行肾替代治疗，优化医疗管理或症状管理应成为护理目标。
