Grupp Clemens
Medizinische Klinik III mit Zentrum für Altersmedizin, Klinikum der Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Deutschland.
Georg-August-Universität, Göttingen, Deutschland.
Z Gerontol Geriatr. 2021 May;54(3):217-222. doi: 10.1007/s00391-021-01860-4. Epub 2021 Feb 25.
The prevalence of frailty is very high in patients with chronic renal insufficiency and increases with its severity. A number of factors associated with chronic renal insufficiency appear to favor the frequent occurrence of frailty in these patients. In addition to its unfavorable impact on the quality of life, morbidity and mortality, frailty is an important criterion in setting treatment goals for chronic kidney disease as well as in the decision whether to undergo dialysis treatment or conservative treatment without dialysis and also in listing a patient for a kidney transplantation. There is still uncertainty about the measures to improve the effects of frailty in patients with chronic kidney insufficiency. These can vary considerably depending on the stage and course of the kidney disease and external circumstances. Individual physical, psychological or emotional problems can be identified on the basis of a geriatric assessment including a social anamnesis. This forms the foundation for tailored measures, such as advice on how to behave when suffering from kidney disease, training therapy and rehabilitation. Patients with renal insufficiency seem to benefit from the latter to a similar extent as patients without kidney disease. Thus, an early assessment of frailty-associated problems in patients with chronic renal insufficiency could help to identify deficits as soon as possible and, by measures adapted to the situation, to achieve an improvement in the quality of life and/or prognosis of these patients.
衰弱在慢性肾功能不全患者中的患病率非常高，且随病情严重程度增加而上升。一些与慢性肾功能不全相关的因素似乎促使这些患者频繁出现衰弱。除了对生活质量、发病率和死亡率产生不利影响外，衰弱还是制定慢性肾脏病治疗目标以及决定是否进行透析治疗或非透析保守治疗以及将患者列入肾脏移植名单的重要标准。对于改善慢性肾功能不全患者衰弱状况的措施仍存在不确定性。这些措施可能因肾脏疾病的阶段和病程以及外部情况而有很大差异。基于包括社会病史在内的老年评估，可以识别个体的身体、心理或情感问题。这为量身定制的措施奠定了基础，例如关于肾病患者行为方式的建议、训练疗法和康复治疗。肾功能不全患者似乎与无肾病患者从后者中获益的程度相似。因此，对慢性肾功能不全患者与衰弱相关问题进行早期评估有助于尽快发现缺陷，并通过因地制宜的措施改善这些患者的生活质量和/或预后。
