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- 相关性肾病患者的诊断、教育与护理:德尔菲共识与系统评价

Diagnosis, Education, and Care of Patients with -Associated Nephropathy: A Delphi Consensus and Systematic Review.

作者信息

Freedman Barry I, Burke Wylie, Divers Jasmin, Eberhard Lucy, Gadegbeku Crystal A, Gbadegesin Rasheed, Hall Michael E, Jones-Smith Tiffany, Knight Richard, Kopp Jeffrey B, Kovesdy Csaba P, Norris Keith C, Olabisi Opeyemi A, Roberts Glenda V, Sedor John R, Blacksher Erika

机构信息

Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Department of Bioethics and Humanities, University of Washington, Seattle, Washington.

出版信息

J Am Soc Nephrol. 2021 Jul;32(7):1765-1778. doi: 10.1681/ASN.2020101399. Epub 2021 Apr 14.

Abstract

BACKGROUND

variants contribute to the markedly higher incidence of ESKD in Blacks compared with Whites. Genetic testing for these variants in patients with African ancestry who have nephropathy is uncommon, and no specific treatment or management protocol for -associated nephropathy currently exists.

METHODS

A multidisciplinary, racially diverse group of 14 experts and patient advocates participated in a Delphi consensus process to establish practical guidance for clinicians caring for patients who may have -associated nephropathy. Consensus group members took part in three anonymous voting rounds to develop consensus statements relating to the following: () counseling, genotyping, and diagnosis; () disease awareness and education; and () a vision for management of -associated nephropathy in a future when treatment is available. A systematic literature search of the MEDLINE and Embase databases was conducted to identify relevant evidence published from January 1, 2009 to July 14, 2020.

RESULTS

The consensus group agreed on 55 consensus statements covering such topics as demographic and clinical factors that suggest a patient has -associated nephropathy, as well as key considerations for counseling, testing, and diagnosis in current clinical practice. They achieved consensus on the need to increase awareness among key stakeholders of racial health disparities in kidney disease and of -associated nephropathy and on features of a successful education program to raise awareness among the patient community. The group also highlighted the unmet need for a specific treatment and agreed on best practice for management of these patients should a treatment become available.

CONCLUSIONS

A multidisciplinary group of experts and patient advocates defined consensus-based guidance on the care of patients who may have -associated nephropathy.

摘要

背景

与白人相比,某些基因变异导致黑人终末期肾病(ESKD)的发病率显著更高。对患有肾病的非洲裔患者进行这些变异的基因检测并不常见,目前也没有针对相关肾病的具体治疗或管理方案。

方法

由14名专家和患者倡导者组成的多学科、种族多元化小组参与了德尔菲共识过程,以为可能患有相关肾病的患者提供临床护理的医生制定实用指南。共识小组成员参加了三轮匿名投票,以制定与以下方面相关的共识声明:(1)咨询、基因分型和诊断;(2)疾病认知和教育;(3)在未来有可用治疗方法时对相关肾病管理的愿景。对MEDLINE和Embase数据库进行了系统的文献检索,以识别2009年1月1日至2020年7月14日发表的相关证据。

结果

共识小组就55项共识声明达成一致,这些声明涵盖了表明患者患有相关肾病的人口统计学和临床因素等主题,以及当前临床实践中咨询、检测和诊断的关键考虑因素。他们就提高关键利益相关者对肾病种族健康差异和相关肾病的认识的必要性,以及成功的提高患者群体认识的教育项目的特点达成了共识。该小组还强调了对特定治疗的未满足需求,并就治疗可用时这些患者管理的最佳实践达成了一致。

结论

一个由专家和患者倡导者组成的多学科小组为可能患有相关肾病的患者的护理定义了基于共识的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75f5/8425659/0c7589c38c2c/ASN.2020101399absf1.jpg

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