臨牀透析 Vol.17 No.1(2-2-1)


特集名 糖尿病性腎症の最前線
題名 糖尿病透析患者の合併症 (1) 透析困難症
発刊年月 2001年 01月
著者 椿原 美治 大阪府立病院腎臓内科
【 要旨 】 透析困難症とは血液透析(HD)中やHD終了後に生じる臨床症状によりHD継続が困難となる病態の総称で,さまざまな要因によって雑多な症状を呈し,とくに糖尿病透析患者に多い.シャントトラブルは狭義の困難症とはいえないが,とくに糖尿病透析患者に多く,HD困難の大きな要因となり,早期の対策が必要である.HDは患者にとって大きな負荷であり,予備力の低下している臓器症状が出現する.このため,単なる対症療法にとどまらず,専門医による原因の究明や治療が重要である.
Theme Forefront of Diabetic Nephropathy
Title Disdialysis syndrome in patients with diabetic nephropathy
Author Yoshiharu Tsubakihara Department of Nephrology, Osaka Prefectural Hospital
[ Summary ] Disdialysis syndrome(DS) is the generic name for hemodialysis(HD)-induced symptoms causing interruption of HD sessions. DS includes mixed symptoms, due to many causes, and occurs very often in patients with diabetic nephropathy(DN). However, blood access problems are not considered to be DS, in by strict definition. DS is common in DN patients and impedes HD. Therefore, it is very important to deal effectively with this problem.
HD is thought to be a strong burden on organs without any functional reserve and causes symptoms related to these organs. Therefore, it is necessary not only to treat these patients symptomatically but also to investigate essential causes and offer radical treatment by specialists for those organs.
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