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慢性肾脏病起始透析适应证

Author
Anthony Bleyer, MD, MS
Section Editors
Steve J Schwab, MD
Jeffrey S Berns, MD
Deputy Editor
Alice M Sheridan, MD
Translators
梁馨苓, 主任医师，教授

引言

对慢性肾脏病(chronic kidney disease, CKD)患者而言，何时开始维持性透析是一个艰难的抉择，需要肾脏科医生与患者共同做出决定。做出这个决定的困难在于，尽管透析可有效治疗尿毒症和液体过剩的症状和体征(有些可能危及生命)，但透析需要终身治疗，给患者带来不适、不便和一些风险。

因此，当透析缓解尿毒症的症状和体征带来的益处超过透析的风险以及它对患者生存质量的影响时，则应开始透析治疗，否则，不应该予以透析治疗。

晚期CKD患者的整体治疗应包括透析准备。理想状态下，患者应有数月时间来考虑肾移植、与医生讨论更好的透析方式并完成合适的透析通路准备，然后才开始透析。

本专题总结终末期肾病(end-stage renal disease, ESRD)患者维持性透析的适应证。其他关于CKD患者的治疗和肾脏替代疗法选择的问题将在别处讨论。 (参见“成人慢性肾脏病治疗概述”和“长期腹膜透析方式的选择”)

急性肾损伤的透析适应证将在别处讨论。 (参见“成人急性肾损伤的肾脏替代疗法(透析)：适应证、时机及透析剂量”，关于‘急诊指征’一节)

         

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Literature review current through: 2017-06 . | This topic last updated: 2017-01-09.
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