Prognosefaktoren bei älteren Dialysepatienten beachten

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.

Publication History

Article published online:
18 May 2022

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