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新冠疫情时代:是时候推广家庭透析和腹膜透析了吗?

COVID-19 pandemic era: is it time to promote home dialysis and peritoneal dialysis?

作者信息

Cozzolino Mario, Conte Ferruccio, Zappulo Fulvia, Ciceri Paola, Galassi Andrea, Capelli Irene, Magnoni Giacomo, La Manna Gaetano

机构信息

Renal Division, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy.

Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.

出版信息

Clin Kidney J. 2021 Feb 2;14(Suppl 1):i6-i13. doi: 10.1093/ckj/sfab023. eCollection 2021 Mar.

Abstract

The novel coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic in March 2020 by the World Health Organization. Older individuals and patients with comorbid conditions such as hypertension, heart disease, diabetes, lung disease, chronic kidney disease (CKD) and immunologic diseases are at higher risk of contracting this severe infection. In particular, patients with advanced CKD constitute a vulnerable population and a challenge in the prevention and control of the disease. Home-based renal replacement therapies offer an opportunity to manage patients remotely, thus reducing the likelihood of infection due to direct human interaction. Patients are seen less frequently, limiting the close interaction between patients and healthcare workers who may contract and spread the disease. However, while home dialysis is a reasonable choice at this time due to the advantage of isolation of patients, measures must be assured to implement the program. Despite its logistical benefits, outpatient haemodialysis also presents certain challenges during times of crises such as the coronavirus disease 2019 (COVID-19) pandemic and potentially future ones.

摘要

新型冠状病毒,即严重急性呼吸综合征冠状病毒2(SARS-CoV-2),于2020年3月被世界卫生组织宣布为大流行病。老年人以及患有高血压、心脏病、糖尿病、肺病、慢性肾脏病(CKD)和免疫性疾病等合并症的患者感染这种严重疾病的风险更高。特别是,晚期CKD患者构成了一个脆弱群体,也是疾病防控工作中的一项挑战。居家肾脏替代疗法为远程管理患者提供了机会,从而降低了因直接人际接触而感染的可能性。患者就诊频率降低,限制了患者与可能感染并传播疾病的医护人员之间的密切接触。然而,尽管由于患者隔离的优势,此时家庭透析是一个合理的选择,但必须确保采取措施来实施该方案。尽管门诊血液透析在后勤方面有诸多益处,但在诸如2019冠状病毒病(COVID-19)大流行以及未来可能出现的危机期间,也存在一定挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b8e/7995524/5954ce319459/sfab023f1.jpg

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