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Dtsch Med Wochenschr 2017; 142(07): 534-540
DOI: 10.1055/s-0042-120808
Review
© Georg Thieme Verlag KG Stuttgart · New York

Akutes Nierenversagen – Optimierungspotenziale zur Gewährleistung einer verbesserten Versorgungsstruktur

Acute Kidney Injury – Potentials to Improve AKI-Related Health Care Structure
Christian Nusshag
1   Klinik für Nephrologie, Universitätsklinikum Heidelberg
,
Konrad Obermann
2   Mannheim Institute of Public Health (MIPH), Universität Heidelberg
,
Markus Weigand
3   Anästhesiologische Klinik, Universitätsklinikum Heidelberg
,
Vedat Schwenger
4   Klinik für Nieren-, Hochdruck- und Autoimmunerkrankungen, Klinikum Stuttgart
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
07. April 2017 (online)

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Zusammenfassung

Seit 2005 hat sich die Zahl der akuten Nierenversagen (ANV) in Deutschland beinahe verdreifacht. Trotz substanzieller ANV-Komplikationen fehlt eine entsprechende Sensibilisierung für das Krankheitsbild. Trotz fehlendem Verfahrensvorteil sind kostenintensive CRRT-Verfahren die dominierende Behandlungsform in der ANV-Therapie. Die Umstellung von 85 % aller CRRT-Behandlungen auf ein IHD-/SLED-Verfahren ermöglicht eine Reduktion der Therapiekosten um bis zu 7,3 Millionen Euro jährlich. Eine entsprechende Reinvestition kann in Zusammenarbeit mit niedergelassenen Nephrologen die Versorgungsqualität verbessern und vermehrt Nierenersatzverfahren in kleinen Kliniken etablieren. Längerfristiges Ziel ist die Etablierung von nationalen Versorgungsleitlinien. Geringere Folgekosten sind ein zentraler Anreiz zur Umsetzung.

Abstract

Since 2005 the AKI numbers nearly increased threefold. The prevailing health care structure for AKI-management in Germany possesses major potential for improvement. Despite a clear advantage regarding mortality and renal recovery, the cost-intensive CRRT is the predominant procedure in AKI-therapy. Conversion of 85 % of the CRRT-procedures to a dialysis procedure (IHD/SLED) enables annual savings in AKI-therapy by 7.3 million Euros. A reinvestment can finance a strengthened collaboration with licensed nephrologists to improve therapy quality and availability of RRT-units in local hospitals. The the long term aim is the establishment of national therapy guidelines. Lower consequential costs are crucial incentives.

Schlüsselwörter

Akutes Nierenversagen (ANV) in Deutschland - Nierenersatzverfahren - Versorgungsstruktur - Ökonomie - systematische Übersicht

Key words

acute kidney injury (AKI) in Germany - renal replacement therapy - health care structure - economics - systematic review
 

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