Hole Barnaby, Hemmelgarn Brenda, Brown Edwina, Brown Mark, McCulloch Mignon I, Zuniga Carlos, Andreoli Sharon P, Blake Peter G, Couchoud Cécile, Cueto-Manzano Alfonso M, Dreyer Gavin, Garcia Garcia Guillermo, Jager Kitty J, McKnight Marla, Morton Rachael L, Murtagh Fliss E M, Naicker Saraladevi, Obrador Gregorio T, Perl Jeffrey, Rahman Muhibur, Shah Kamal D, Van Biesen Wim, Walker Rachael C, Yeates Karen, Zemchenkov Alexander, Zhao Ming-Hui, Davies Simon J, Caskey Fergus J
UK Renal Registry, Learning and Research, Southmead Hospital, Bristol, UK.
Population Health Sciences, University of Bristol, Bristol, UK.
Kidney Int Suppl (2011). 2020 Mar;10(1):e86-e94. doi: 10.1016/j.kisu.2019.11.008. Epub 2020 Feb 19.
A key component of treatment for all people with advanced kidney disease is supportive care, which aims to improve quality of life and can be provided alongside therapies intended to prolong life, such as dialysis. This article addresses the key considerations of supportive care as part of integrated end-stage kidney disease care, with particular attention paid to programs in low- and middle-income countries. Supportive care should be an integrated component of care for patients with advanced chronic kidney disease, patients receiving kidney replacement therapy (KRT), and patients receiving non-KRT conservative care. Five themes are identified: improving information on prognosis and support, developing context-specific evidence, establishing appropriate metrics for monitoring care, clearly communicating the role of supportive care, and integrating supportive care into existing health care infrastructures. This report explores some general aspects of these 5 domains, before exploring their consequences in 4 health care situations/settings: in people approaching end-stage kidney disease in high-income countries and in low- and middle-income countries, and in people discontinuing KRT in high-income countries and in low- and middle-income countries.
对所有晚期肾病患者而言，治疗的一个关键组成部分是支持性护理，其旨在提高生活质量，并且可以与旨在延长生命的疗法（如透析）同时提供。本文探讨了支持性护理作为终末期肾病综合护理一部分的关键考量因素，特别关注低收入和中等收入国家的项目。支持性护理应成为晚期慢性肾病患者、接受肾脏替代治疗（KRT）的患者以及接受非KRT保守治疗的患者护理的一个综合组成部分。确定了五个主题：改善预后和支持方面的信息、制定因地制宜的证据、建立监测护理的适当指标、明确传达支持性护理的作用以及将支持性护理纳入现有的医疗保健基础设施。本报告先探讨这五个领域的一些一般方面，然后探讨它们在四种医疗保健情况/背景下的影响：高收入国家和低收入及中等收入国家中接近终末期肾病的人群，以及高收入国家和低收入及中等收入国家中停止KRT的人群。
