North Florida/South Georgia Veterans Health System, Gainesville, Florida.
Division of Nephrology, Hypertension, and Transplantation, Department of Medicine, University of Florida, Gainesville, Florida.
Clin J Am Soc Nephrol. 2023 Sep 1;18(9):1234-1243. doi: 10.2215/CJN.0000000000000170. Epub 2023 May 8.
Kidney health advocacy organizations and leaders in the nephrology community have repeatedly emphasized the need to increase home dialysis utilization in the United States. Limited awareness and understanding of options for the management of kidney failure among patients living with advanced CKD is a significant barrier to increasing the selection and use of home dialysis. Studies have shown that providing targeted comprehensive patient education before the onset of kidney failure can improve patients' awareness of kidney disease and substantially increase the informed utilization of home dialysis. Unfortunately, in the absence of validated evidence-based education protocols, outcomes associated with home dialysis use vary widely among published studies, potentially affecting the routine implementation and reporting of these services among patients with advanced CKD. This review provides pragmatic guidance on establishing effective patient-centered education programs to empower patients to make informed decisions about their KRT and, in turn, increase home dialysis use.
肾脏健康倡导组织和肾脏病学领域的领导者反复强调，需要增加美国的家庭透析利用率。患有晚期 CKD 的患者对肾衰竭管理选择的认知和理解有限，这是增加家庭透析选择和使用的重大障碍。研究表明，在肾衰竭发生之前提供有针对性的综合患者教育，可以提高患者对肾脏疾病的认识，并大幅增加家庭透析的知情使用。不幸的是，由于缺乏经过验证的基于证据的教育方案，发表的研究中家庭透析使用相关结果差异很大，这可能会影响晚期 CKD 患者中这些服务的常规实施和报告。本综述提供了关于建立有效的以患者为中心的教育计划的实用指导，以使患者能够对他们的 KRT 做出明智的决策，并进而增加家庭透析的使用。
