Renal Unit, Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Department of Internal Medicine , University of Würzburg, Würzburg, Germany.
Nephrol Dial Transplant. 2020 Mar 1;35(Suppl 2):ii4-ii10. doi: 10.1093/ndt/gfaa022.
People with advanced chronic kidney disease and evidence of progression have a high risk of renal replacement therapy. Specialized transition clinics could offer a better option for preparing these patients for dialysis, transplantation or conservative care. This review focuses on the different aspects of such transition clinics. We discuss which patients should be referred to these units and when referral should take place. Patient involvement in the decision-making process is important and requires unbiased patient education. There are many themes, both patient-centred and within the healthcare structure, that will influence the process of shared decision-making and the modality choice. Aspects of placing an access for haemodialysis and peritoneal dialysis are reviewed. Finally, we discuss the importance of pre-emptive transplantation and a planned dialysis start, all with a focus on multidisciplinary collaboration at the transition clinic.
患有晚期慢性肾病且有进展证据的患者有接受肾脏替代治疗的高风险。专门的过渡诊所可为这些患者准备透析、移植或保守治疗提供更好的选择。本综述重点介绍了这些过渡诊所的不同方面。我们讨论了哪些患者应转至这些单位以及何时应进行转介。患者在决策过程中的参与很重要，需要进行无偏见的患者教育。有许多主题，包括以患者为中心的主题和医疗保健结构内的主题，都会影响共同决策过程和模式选择。本文回顾了血液透析和腹膜透析置管的相关方面。最后，我们讨论了抢先移植和计划透析开始的重要性，所有这些都侧重于过渡诊所的多学科合作。
