Nová evropská doporučení pro management pacientů vyššího věku s chronickým onemocněním ledvin ve stadiu 3b a vyšším (eGFR < 45 ml/min/1,73 m2)


Authors: E. Topinková;  V. Teplan
Published in: Geriatrie a Gerontologie 2017, 6, č. 1: 5-15
Category:

Overview

Physicians across discipline see older patients with advanced chronic kidney disease (CKD) and are facing difficult decisions regarding future treatment of these patients including decision if/if not to start dialysis. Therefore we present to Czech readers in a shorter form the recently published European guidelines on management of older patients with advanced CKD stage 3b and higher. New Guidelines focus on 6 problem areas of diagnosis and treatment: (1) estimation of GFR for classification and dose adaptation; (2) prognosticating rate of progression to end-stage renal disease; (3) prognosticating risk of death in medium term periods; (4) assessment of functional status and strategies to improve it; (5) assessment of nutritional status and strategies to improve it; (6) appraisal of benefits and drawbacks of renal replacement therapy versus conservative treatment. Based on thorough evaluation of scientific evidence the recommendations for clinical practice were formed. We do believe that knowledge of CKD differences in seniors will translate into improved medical care for these patients.

Keywords:
Ageing – chronic kidney disease (CKD) 3b and higher – CKD management – frailty – guidelines


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