| 特集名 | 移植腎機能喪失後の透析再導入とケア | |
|---|---|---|
| 題名 | ［各論］透析を経ないで腎移植が行われた患者の透析導入 -- 患者指導と患者心理のケア | |
| 発刊年月 | 2006年 09月 | |
| 著者 | 酒井 謙 | 東邦大学医学部腎臓学教室 |
| 著者 | 河村 毅 | 東邦大学医学部腎臓学教室 |
| 著者 | 相川 厚 | 東邦大学医学部腎臓学教室 |
| 著者 | 長谷川 昭 | 西横浜国際総合病院 |
| 【 要旨 】 | 移植腎生着率は未透析移植で有意に良好である．未透析移植のおもな対象は小児慢性腎不全であり，欧米のガイドラインでも未透析移植を推進するべきと明記されている． 未透析移植では，透析の実体験がないゆえに免疫抑制薬の服薬コンプライアンスが問題になる．未透析移植という治療選択決定には主治医の意向が強く影響し，治療への理解・受容を深める努力を家族とともに時間をかけて行うべきである．未透析移植において移植腎機能廃絶により透析導入を行う場合は，初めての経験である透析における生活指導は非常に重要である．一方で，二次移植に向けて目的をもって透析生活を送る援助が必要である． |
|
| Theme | Dialysis Re-initiation and Related Cares after Functional Loss of Transplanted Kidney | |
|---|---|---|
| Title | A problem of entering dialysis after pre-emptive renal transplantation | |
| Author | Ken Sakai | Department of Nephrology, Toho University School of Medicine |
| Author | Takeshi Kawamura | Department of Nephrology, Toho University School of Medicine |
| Author | Atsushi Aikawa | Department of Nephrology, Toho University School of Medicine |
| Author | Akira Hasegawa | Nishi Yokohama International Hospital |
| [ Summary ] | Preemptive renal transplantation is known to be another treatment of choice for patients with end-stage renal disease. It may be compared to transplantation which is performed after various periods of dialytic therapy. This treatment allows us to maintain a high quality of life, have better graft survival rates and employ cost-effective options. It is also important for pediatric end-stage renal disease patients, in relation to growth problems. In terms of starting dialysis after preemptive renal transplantation from graft loss, non-compliance with drugs for immunosuppression is a major problem among patients who never underwent dialysis. Preemptive transplantation should be taken into consideration as an initial form of therapy in order to formulate lifelong plans for end-stage renal disease. However, continuous education to maintain graft functionality is more important in preemptive than in non-preemptive transplantation. |
|