Prognosefaktoren bei älteren Dialysepatienten beachten

Linus Alexander Völker; Paul Thomas Brinkkötter

doi:10.1055/a-1746-0465

Dialyse aktuell, Table of Contents

Dialyse aktuell 2022; 26(04): 167-173
DOI: 10.1055/a-1746-0465

Schwerpunkt

Dialyse

Prognosefaktoren bei älteren Dialysepatienten beachten

Management von multimorbiden Patienten mit terminaler Niereninsuffizienz

Linus Alexander Völker

¹Klinik II für Innere Medizin, Nephrologie, Diabetologie, Rheumatologie und Allgemeine Innere Medizin, Uniklinik Köln

,

Paul Thomas Brinkkötter

¹Klinik II für Innere Medizin, Nephrologie, Diabetologie, Rheumatologie und Allgemeine Innere Medizin, Uniklinik Köln

› Author Affiliations

Abstract

ZUSAMMENFASSUNG

Der Anteil betagter und hochbetagter Patienten mit terminaler Niereninsuffizienz hat aufgrund der demografischen Entwicklung und der besseren medizinischen Versorgung deutlich zugenommen. Ob jedoch die Einleitung der Dialyse mit einem Überlebensvorteil und/oder einer Verbesserung der Lebensqualität einhergehen, ist umstritten. Dies betrifft insbes. multimorbide und gebrechliche („frail”) Patienten. Zur optimalen Patienten- und Angehörigenberatung gehören deshalb Kenntnisse zu prognostisch relevanten Faktoren, um im Sinne einer partizipativen Entscheidungsfindung („shared decision making“) das Vorgehen festzulegen – sowohl im Hinblick auf die Dialysebehandlung als auch auf die Formen des konservativen Krankheitsmanagements. Die aktuell verfügbaren Prognosefaktoren entstammen zumeist retrospektiven Registerstudien und sind somit einer ausgeprägten Verzerrung („bias“) ausgesetzt. Neben dem erforderlichen nephrologischen Fachwissen ist eine altersmedizinische Expertise hilfreich, um eine optimale Versorgung der Patienten zu gewährleisten.

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References

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