如何与老年人共同决定终末期肾病的治疗？老年肾脏病学的附加值

IF 3.9 2区医学 Q1 UROLOGY & NEPHROLOGY

Clinical Kidney Journal Pub Date : 2024-09-06 DOI:10.1093/ckj/sfae281

Florent Guerville, Marion Pépin, Antoine Garnier-Crussard, Jean-Baptiste Beuscart, Salvatore Citarda, Aldjia Hocine, Cédric Villain, Thomas Tannou

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引用次数: 0

摘要

改善对患有终末期肾病（ESKD）的老年人的护理需要调整标准以满足他们的需求。由于他们在多病症、虚弱、认知能力下降和医疗保健优先事项方面的异质性，这可能会很复杂。由于这些患者的获益和风险都不确定，因此选择合适的治疗方法是肾科医生每天都要面对的挑战。在这篇叙述性综述中，我们旨在(1) 描述与老年人医疗保健相关的问题，特别关注决策过程；(2) 将这些概念应用于 ESKD；(3) 确定共同决策的组成部分和模式；(4) 提出改善护理路径的方法。为此，我们提出了一种老年医学-肾脏病学动态，即这些专科之间的必要合作。在强调该领域现有证据的不足后，我们提出了优先研究方向。

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How to make a shared decision with older persons for end-stage kidney disease treatment? The added value of geronto-nephrology

Improving care for older people with end-stage kidney disease (ESKD) requires standards to be adapted to meet their needs. This may be complex due to their heterogeneity in terms of multimorbidity, frailty, cognitive decline, and healthcare priorities. As benefits and risks are uncertain for these persons, choosing an appropriate treatment is a daily challenge for nephrologists. In this narrative review, we aimed to: (1) describe the issues associated with healthcare for older people, with a specific focus on decision-making processes; (2) apply these concepts to the context of ESKD; (3) identify components and modalities of shared decision-making, and (4) suggest means to improve care pathways. To this end, we propose a geronto-nephrology dynamic, described here as the necessary collaboration between these specialties. Underscoring gaps in the current evidence in this field led us to suggest priority research orientations.

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来源期刊

Clinical Kidney Journal Medicine-Transplantation

CiteScore

6.70

自引率

10.90%

发文量

242

审稿时长

8 weeks

期刊介绍： About the Journal Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.