an Associate Chief Nursing Officer, Advanced Practice Providers; a Nurse Practitioner, Nephrology and Palliative Care, Truman Medical Centers, Kansas City, MO.
member of ANNA's Heart of America Chapter.
Nephrol Nurs J. 2021 Jan-Feb;48(1):69-76.
Multiple studies document there are patients for whom hemodialysis can be predicted not to offer a survival advantage. The medical evidence also includes reports of strong, active medical management without dialysis programs in Australia, Canada, and the United Kingdom, yet the nephrology community in the United States has yet to provide to patients with end stage kidney disease an active medical management without dialysis option available throughout the country. This article reviews barriers and facilitators to starting such a program and offers recommendations for the components that have enabled international programs to be successful.
多项研究证明，对于某些患者而言，血液透析并不能带来生存优势。医学证据还包括澳大利亚、加拿大和英国的报告，这些报告称在不进行透析的情况下，采取强有力的积极医疗管理措施也能取得良好效果，但美国的肾病学界尚未向终末期肾病患者提供在全国范围内开展不透析积极医疗管理的选择。本文回顾了启动此类项目的障碍和促进因素，并就能够使国际项目取得成功的相关要素提出了建议。
