老年末期腎臟病與腎臟替代療法

Renal Replacement Therapy in Geriatric End Stage Renal Disease Patients

10.6340/KD.2016.28(3).06

吳泰德(Tai-Te Wu)；張志宗(Chiz-Tzung Chang)

高齡透析 ； 血液透析 ； 腹膜透析 ； 腎臟移植 ； geriatric dialysis ； hemodialysis ； peritoneal dialysis ； renal transplantation

腎臟與透析

28卷3期（2016 / 09 / 01）

130 - 133

繁體中文

台灣的末期腎臟病 (ESRD) 盛行率世界最高，除糖尿病等慢性病病人增加外，人口老化更是重要的原因。根據《2015 台灣腎臟病年報》，65 歲以上新發生透析患者數占該年全部新發生透析患者數的比例於2005 年首次超過50%，至2013 年時已增加到約55%。老年ESRD 病人除腎臟衰竭外常合併退化性疾病和其他慢性疾病，因此臨床照顧上有不同於年輕病人的考量範疇。另外關於共病嚴重預後差的老年ESRD 病人是否需要使用腎臟替代療法延命，是醫學倫理範圍的重要議題。

Taiwan has highest end-stage renal disease prevalence in the world, beside the increasing of type II DM and other chronic disease patients, population aging is another important reason. According ＂2015 Annual Report on Kidney Disease in Taiwan＂ ESRD patients older than 65 years firstly became over 50% of Taiwan all incident ESRD patients in 2005 and then had been increasing to 55% until 2013. Except renal failure, geriatric ESRD patients usually concurrent with degenerative disease and other chronic disease, so we should have different thinking in caring elderly ESRD patients to young ESRD patient. On the other hand, the necessity of having renal replacement therapy in those elderly ESRD patients who are with severe comorbidity and poor prognosis, is one of important ethical issue has be discussed.

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