| 特集名 | 透析関連専門資格に求められるもの・これからの透析医療教育―現状と課題 | |
|---|---|---|
| 題名 | ［各論/医師］4. 小児科系医師と透析専門医：役割と課題 | |
| 発刊年月 | 2014年 06月 | |
| 著者 | 藤丸 拓也 | 聖路加国際病院腎臓内科 |
| 著者 | 小松 康宏 | 聖路加国際病院腎臓内科 |
| 【 要旨 】 | 小児の腎不全患者は非常に少ないが，彼らへ“子どもらしい生活”を提供することはきわめて重要である．しかし，一般小児科医では透析医療の経験がほとんどなく，成人分野の透析専門医では小児の特殊性への対応が難しい． 小児の腎不全医療は，(1) 成人とは異なる原疾患，(2) 高い腹膜透析選択率，(3) 身体的および精神的な発達への配慮，(4) 技術的特殊性，など小児特有の対応が必要となる．そのため小児の透析専門医の存在は不可欠である． 本稿では，小児腎不全の疫学や特殊性を概説し，小児科医が現行の透析専門医資格を取得する際の課題について述べた． |
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| Theme | Certification system for dialysis specialists ; its present status and future in Japan | |
|---|---|---|
| Title | Necessity of specialist in pediatric dialysis | |
| Author | Takuya Fujimaru | Division of Nephrology, Department of Medicine, St. Luke's International Hospital |
| Author | Yasuhiro Komatsu | Division of Nephrology, Department of Medicine, St. Luke's International Hospital |
| [ Summary ] | Although the number of pediatric patients with end stage renal disease (ESRD) is far smaller compared to that of adult, providing appropriate care for them is very important. Multiple distinctive characteristic of pediatric ESRD patients demands the specialist who has profound knowledge, skill, and experience in both pediatrics and nephrology. The causes of ESRD of children are different from those of adult； peritoneal dialysis is most common dialysis modality for children ; consideration for physical, psychological, and social development is required； special technical expertise is required for pediatric dialysis patients. From these reasons, general pediatrician alone cannot take care of these patients since they lack the expertise in dialysis ; adult nephrologist alone cannot take care of them either, because they have difficulty in managing pediatric care. In this article, we outline the etiology and characteristics of pediatric ESRD, and discuss the issues on training and qualification of pediatric nephrology/dialysis specialist. | |