Sống sót lâu dài ở bệnh thận mạn tính

K.-H. Schulz1,2, F. Thaiss3
1Klinik und Poliklinik für Hepatobiliäre Chirurgie und Transplantationschirurgie und Institut für Medizinische Psychologie, Universitätsklinikum Eppendorf, Hamburg, Deutschland
2Institut für Medizinische Psychologie, Universitätsklinikum Eppendorf, Hamburg, Deutschland
3III. Medizinische Klinik und Poliklinik, Universitätsklinikum Eppendorf, Hamburg, Deutschland

Tóm tắt

Ở giai đoạn cuối của suy thận mạn, một liệu pháp thay thế thận thông qua điều trị lọc máu hoặc ghép thận là cần thiết. Thời gian sống sót và chất lượng cuộc sống (QOL) của bệnh nhân với suy thận giai đoạn cuối tốt hơn sau khi ghép thận thành công so với khi điều trị bằng lọc máu mãn tính. Càng sớm thực hiện ghép thận, tỷ lệ sống sót của bệnh nhân và phần thận cấy ghép càng tốt. Vì vậy, ghép thận từ người cho sống hiến tặng trước khi bắt đầu lọc máu là biện pháp y tế tốt nhất cho những bệnh nhân này. Bệnh nhân bị bệnh thận giai đoạn cuối phải đối mặt với nhiều vấn đề thể chất và tâm lý. Tỷ lệ mắc rối loạn trầm cảm trong dân số này được ước tính là 20-25%. Các nghiên cứu trên trẻ em đã ghép thận cho thấy chất lượng cuộc sống bị hạn chế về mặt thể chất nhưng nhìn chung có chất lượng cuộc sống tốt trong lĩnh vực tâm lý. Một kết quả đáng lo ngại là tỷ lệ không tuân thủ điều trị cao trong nhóm thanh thiếu niên. Cụ thể, các can thiệp trị liệu vận động trong khi điều trị lọc máu và sau khi ghép thận cho thấy kết quả khả quan trong các nghiên cứu hiện có. Các nghiên cứu trong tương lai cần xác định cách mà các phương pháp điều trị mới về ức chế miễn dịch có thể ảnh hưởng đến chất lượng cuộc sống.

Từ khóa

#suy thận mạn tính #ghép thận #chất lượng cuộc sống #bệnh nhân #ức chế miễn dịch

Tài liệu tham khảo

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