Dialysis and the Elderly: An Underestimated Problem

被引:35
作者
Buemi, Michele [1 ]
Lacquaniti, Antonio [1 ]
Bolignano, Davide [1 ]
Donato, Valentina [1 ]
Fazio, Maria Rosaria [1 ]
Campo, Susanna [1 ]
Coppolino, Giuseppe [1 ]
Sturiale, Alessio [1 ]
机构
[1] Univ Messina, Dept Internal Med, Chair Nephrol, Messina, Italy
关键词
Uremia; Dialysis; Elderly; Vascular access; Quality of life;
D O I
10.1159/000164277
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
In developed countries, the incidence of end-stage renal failure is constantly increasing, and uremia will soon be a disease typically found in mature and elderly adults. Almost invariably, the physical condition of the elderly patient with terminal uremia is extremely poor, and therapeutic approach complex. Frequent co-morbidity, treatment with many different drugs, the high risk of iatrogenic damage, advanced age and socio-environmental conditions further complicate the management of these patients. While replacement therapy may become necessary, peritoneal dialysis may have advantages over hemodialysis. Peritoneal dialysis causes less hemodynamic stress, does not necessitate vascular access and allows mobility, although it incurs a high incidence of peritonitis and vascular disease. Where hemodialysis is the only feasible treatment, procedures used for vascular access are frequently followed by several complications, representing an important cause of morbidity and hospitalization. In addition, even if it may improve the patient's quality of life, vascular condition, intradialytic hypotension, heart disease, intestinal bleeding and amyloidotic arthropathy are critical aspects of dialysis in the elderly patient. Therefore, particular attention from clinicians and administrators is required and the best possible strategies must be identified in order to provide effective and appropriate services to address these special patients' needs. Copyright (C) 2008 S. Karger AG, Basel
引用
收藏
页码:330 / 336
页数:7
相关论文
共 42 条
[1]   Opinions of elderly people on treatment for end-stage renal disease [J].
Ahmed, S ;
Addicott, C ;
Qureshi, M ;
Pendleton, N ;
Clague, JE ;
Horan, MA .
GERONTOLOGY, 1999, 45 (03) :156-159
[2]  
Alloatti S, 2002, G Ital Nefrol, V19, P622
[3]   Nutritional status of haemodialysis patients: a French national cooperative study [J].
Aparicio, M ;
Cano, N ;
Chauveau, P ;
Azar, R ;
Canaud, B ;
Flory, A ;
Laville, M ;
Leverve, X .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1999, 14 (07) :1679-1686
[4]   Daily nutrient intake represents a modifiable determinant of nutritional status in chronic haemodialysis patients [J].
Bellizzi, V ;
Di Iorio, BR ;
Terracciano, V ;
Minutolo, R ;
Iodice, C ;
De Nicola, L ;
Conte, G .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2003, 18 (09) :1874-1881
[5]   Lessons from 494 permanent accesses in 348 haemodialysis patients older than 65 years of age: 29 years of experience [J].
Berardinelli, L ;
Vegeto, A .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1998, 13 :73-77
[6]  
Bernardini J, 2006, PERITON DIALYSIS INT, V26, P625
[7]   Muscle protein metabolism during hemodialysis [J].
Bohé, J ;
Rennie, MJ .
JOURNAL OF RENAL NUTRITION, 2006, 16 (01) :3-16
[8]  
Bonforte G, 2000, J Vasc Access, V1, P144
[9]  
Brunori G, 2000, J Vasc Access, V1, P134
[10]   Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: A prospective randomized multicenter controlled study [J].
Brunori, Giuliano ;
Viola, Battista F. ;
Parrinello, Giovanni ;
De Biase, Vincenzo ;
Como, Giovanna ;
Franco, Vincenzo ;
Garibotto, Giacomo ;
Zubani, Roberto ;
Cancarini, Giovanni C. .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2007, 49 (05) :569-580