Department of Nephrology, Great Ormond Street Hospital for Children, London, UK.
Department of Cardiology, Great Ormond Street Hospital for Children, London, UK.
Hemodial Int. 2020 Oct;24(4):E61-E66. doi: 10.1111/hdi.12872. Epub 2020 Aug 25.
When faced with patients with deteriorating cardiac disease, nephrologists tend to accept that heart disease is unmodifiable, accepting mediocrity and opting for stabilization. Likewise cardiac patients with persistent renal failure are presented with a poor renal prognosis and prepared for renal transplantation. We present three dialysis dependent children with moderate-to-severe cardiac failure in whom home hemodialysis normalized the cardiac function and restored renal function. These cases highlight the medical benefits of home hemodialysis in severe cardio-renal cases but not without acknowledgement of the resource, commitment, and safety challenges that accompanies them.
当面对心脏疾病恶化的患者时，肾病学家往往接受心脏疾病是不可改变的，接受平庸并选择稳定。同样，患有持续性肾衰竭的心脏病患者的肾脏预后较差，需要进行肾移植。我们介绍了三例依赖透析的儿童，他们患有中度至重度心力衰竭，在家进行血液透析使心脏功能正常化并恢复了肾功能。这些病例突出了家庭血液透析在严重心肾病例中的医疗益处，但也不能忽视随之而来的资源、承诺和安全挑战。
