| 特集名 | 移植腎機能喪失後の透析再導入とケア | |
|---|---|---|
| 題名 | ［各論］移植腎機能廃絶後の代替治療選択 | |
| 発刊年月 | 2006年 09月 | |
| 著者 | 高橋 公太 | 新潟大学大学院医歯学総合研究科腎泌尿器病態学分野 |
| 【 要旨 】 | 末期腎不全の有効な治療手段として透析療法と腎移植があり，後者は，とくにQOLの高い根治的治療である．移植腎機能が低下し，尿毒症に至れば最終的にこの二つの治療のどちらかを選択する必要性があるので，あらかじめ医師は患者と相談しておくことが大切である． 患者にとって代替治療を選択することは一大決意であるが，これらの治療から逃れたい一心に尿毒症状態を安易に延ばし延ばしにすると予後不良となる． 医師がこれらの治療の長所と短所を説明したうえで，患者本人が希望する治療法を選択できるのが理想的な医療である．しかし，現実には患者のもつさまざまな合併症や献腎提供の少ないわが国では，必ずしも患者が希望する治療法を選択できないことが多い． 今回は，移植腎機能が廃絶した場合，次の代替治療をどのように選択すればよいか検討を加えた． |
|
| Theme | Dialysis Re-initiation and Related Cares after Functional Loss of Transplanted Kidney | |
|---|---|---|
| Title | Alternative treatment options after kidney graft loss | |
| Author | Kota Takahashi | Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University |
| [ Summary ] | There are two treatment modalities available for end-stage renal failure ; dialysis and renal transplantation. The latter is a radical therapy with a very high QOL. When the transplanted kidney malfunctions and uremic levels rise, the patient eventually must choose a treatment option. Therefore, it is important for them to discuss those choices with the physician beforehand. It is a major decision for a patient to select an alternative treatment. However, to postpone the decision and leave the uremia as is because of fear of the two alternatives, may lead to a poor prognosis. The ideal treatment is provided when the patient can select the desired option by having a clear explanation provided by the physician, keeping in mind both the advantages and disadvantages of those methods. Unfortunately, it is often difficult for patients to have the desired treatment in Japan, due to various complications or the limited numbers of donor kidneys available. In this paper, we also considered how to select subsequent alternative treatment after the loss of renal function by the transplanted kidney. |
|