| 特集名 | 透析スタッフに必要な腎移植医療の知識2013 | |
|---|---|---|
| 題名 | 透析療法と腎移植 | |
| 発刊年月 | 2013年 08月 | |
| 著者 | 村松 真樹 | 東邦大学医学部腎臓学講座 |
| 著者 | 宍戸 清一郎 | 東邦大学医学部小児腎臓学講座 |
| 著者 | 相川 厚 | 東邦大学医学部腎臓学講座 |
| 【 要旨 】 | 近年，腎移植実施件数は増加傾向を示し，腎移植は一般的な腎代替療法として普及してきている．今後，腎不全に携わる医師は移植医療に関わる機会が多くなることから，透析療法のみならず移植診療に対して理解が求められる．移植前には最適な移植の導入時期や先行的腎移植の是非について検討し，移植腎機能廃絶後には透析管理を支障なく行う必要がある．個々の患者に合わせた包括的腎不全医療を提供するため，生涯にわたる腎不全に対し長期的な計画に基づいて腎代替療法を選択し，透析または移植の継続性を保つことが望まれる． | |
| Theme | Necessary kidney transplant knowledge for the dialysis staff, 2013 | |
|---|---|---|
| Title | Dialysis therapy and kidney transplantation | |
| Author | Masaki Muramatsu | Department of Nephrology, Nephrology, Toho University Faculty of Medicine |
| Author | Seiichiro Shishido | Department of Pediatric Nephrology, Toho University Faculty of Medicine |
| Author | Atsushi Aikawa | Department of Nephrology, Nephrology, Toho University Faculty of Medicine |
| [ Summary ] | Once a kidney has failed, the patient faces three renal replacement therapy (RRT) options : hemodialysis, peritoneal dialysis or kidney transplantation (KT). Selection of the proper type of RRT depends on many variables. The use of KT in Japan has recently increased. KT has become popular as a common form of RRT. End-stage kidney disease treatment requires adequate pre- and post-transplant management. Increased dialysis duration before KT has been shown to deleteriously affect patient and graft survival in several retrospective analyses. Moreover, some reports have shown improved graft survival rates in preemptive kidney transplant recipients compared to those who received pre-transplant dialysis. The timing of KT should be decided on according to optimal prognoses. The increased use of KT is associated with an increase in the number of dialysis patients for whom renal graft functions fail. Therefore, indications for dialysis after KT must include appropriate management, bearing in mind that patients may undergo more than one procedure over the course of their life. Appropriate treatment must also be decided on through cooperation between nephrologists, dialysis specialists and transplant surgeons, with an emphasis on transition continuity between treatment stages. |
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