臨牀透析 Vol.30 No.3(4)


特集名 腎代替療法の多様化と看護の新しい役割―標準化と個別化の視点から
題名 腎移植を受けた患者における個別性のある関わりと実践
発刊年月 2014年 03月
著者 野口 文乃 北里大学病院看護部／移植医療支援室・レシピエント移植コーディネーター
【 要旨 】 腎移植患者は移植後も慢性腎臓病は完治しない．また，免疫抑制薬の服用や感染予防など，さまざまな自己管理が課せられ，それは移植腎の長期生着を左右する．本邦では，2011年度にレシピエント移植コーディネーター（以下，RTC）の認定制度が開始され，2012年4月の診療報酬改定で「移植後患者指導管理料」が新設された．そこでRTCや看護師をはじめとするコメディカルが果たす役割は大きい．移植の特殊性に配慮した専門的な外来管理が評価され，患者指導や教育は継続される．しかしながら移植腎は永久ではない．いつかは透析療法への道をたどる患者も少なくない．そこで移植後も腎不全医療全般の看護が重要な役割を果たす．
Theme From the point of view of individualization and standardization -- New role of nursing and diversification of renal replacement therapy
Title Individual relationships and practices for post renal transplant patients
Author Fumino Noguchi Kitasato University Hospital Nursing Department (clinical transplant coordinator)
[ Summary ] Renal-transplant recipients with chronic kidney disease do not fully recover after transplants. In addition, patients who receive renal transplants must take immunosuppressive drugs and take various self-management measures including prevention of infectious disease, to insure long-term graft survival of the transplanted kidney. An authorization system for recipient transplant coordinators (RTC) was started in 2011 in Japan. Post transplant instruction management systems were initiated in the medical treatment revisions put in place in April of 2012. Therefore, the roles which medical providers, including RTCs and the nurses play is vital. It is necessary that management for specialized outpatient departments in change of the transplants, provide patient education. However, the transplanted kidney function times are limited. Many patients must eventually return to dialysis therapy. Therefore, nursing to treat overall chronic kidney disease plays an important role after renal transplantation.
戻る