老年透析患者的相关临床问题探讨

Preferred strategy for dialysis in older adults

人口老龄化日益加剧,终末期肾病(end stage renal disease,ESRD)老年人群急剧上升。我国流行病学调查发现透析患者中增长最快的是老年人。老年ESRD患者不仅面临肾功能恶化的威胁,还面临衰老、衰弱和共病的影响。本文就老年透析的相关问题进行探讨,包括评估老年ESRD患者是否适合做透析,透析是否符合患者的总体目标,老年透析患者衰弱和认知障碍,老年透析方式的选择,老年透析血管通路的决策点等方面。

Population aging is a growing public health problem.The number of older adults with end stage renal disease(ESRD)is rising dramatically.Epidemiological surveys in China found that the fastest growing number of dialysis patients are the elderly.Older adults with ESRD face not only the threat of deteriorating kidney function,but also the effects of aging,frailty,and comorbidities.This review discussed the issues related to dialysis in older adults,including assessing whether elderly ESRD patients are suitable for dialysis,whether dialysis meet the overall goals of patients,frailty and cognitive impairment in older dialysis patients,the choice of dialysis methods in older adults,and the decision points of dialysis vascular access.