Der Nephrologe

, Volume 9, Issue 1, pp 20–25

Besonderheiten in der Therapie von Nierenerkrankungen im Alter

Leitthema
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Zusammenfassung

Hintergrund

Aufgrund der immer älter werdenden Gesellschaft und der zunehmenden Lebenserwartung spielen die Geriatrie und auch die geriatrische Nephrologie eine immer wichtigere Rolle in der Medizin. Die Behandlung von Nierenerkrankungen im Alter setzt sich oft aus einer komplexen medikamentösen Therapie zusammen; zudem hat die ältere Bevölkerung nicht selten multiple Komorbiditäten. Weiterhin werden aufgrund von anatomischen und physiologischen Veränderungen der Niere normalerweise einfache Behandlungsmethoden zu komplexen Geflechten aus therapeutischen Strategien. Darüber hinaus kommt es, bedingt durch den schwierigen vaskulären Zugang und das erhöhte Auftreten von kardiovaskulären Erkrankungen, häufiger zu Schwierigkeiten während der Dialyse.

Schlussfolgerung

Um eine optimale Behandlung zu garantieren, ist die Berücksichtigung der oben genannten Punkte essenziell. Die Entwicklung von optimalen diagnostischen Verfahren und Formeln, die Entscheidung, welche diagnostischen Verfahren angewandt werden sollten, um den Patienten den größtmöglichen Vorteil zu bieten, spielen bei Älteren eine extrem wichtige Rolle. Medizinische und ethische Aspekte sind miteinander in einem komplexen System verflochten. Der Nephrologe spielt eine essenzielle Rolle in der Versorgung der Patienten. Dieser Artikel diskutiert die häufigsten nephrologischen Komplikationen im Alter und erläutert, was man bei der Behandlung berücksichtigen sollte.

Schlüsselwörter

Nephrologie Geriatrie Polypharmazie Therapie Chronische Erkrankung 

Special aspects in the therapy of renal disease in elderly patients

Abstract

Background

Due to the aging population and increasing life span, geriatrics and thus geriatric nephrology have become important topics in medical care. Treatment of kidney disease in the elderly often consists of complicated pharmaceutical therapy. Elderly patients often have multiple comorbidities and also due to the anatomical and physiological changes in the kidneys, normally straightforward treatment procedures become vastly complicated networks of therapeutic strategies. Additionally, difficulties during dialysis are more frequent in elderly patients due to a difficult vascular access and an increased occurrence of cardiovascular problems.

Conclusions

To allow an optimal treatment, considerations of all these factors is essential. Developing optimal diagnostic procedures and algorithms, deciding which diagnostic procedures should be applied and give benefit to the patient have become major challenges in therapeutic strategies. Medical and ethical considerations are entwined in a complex system consequently nephrologists play a key role in patient care. This article discusses the most common nephrological complications in the elderly which must be taken into consideration in the treatment.

Keywords

Nephrology Geriatrics Polypharmacy Therapy Chronic disease 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Zentrum für Innere Medizin, Schwerpunkt NephrologieUniversitätsklinikum Gießen und Marburg GmbH, Standort MarburgMarburgDeutschland
  2. 2.Medizinische Klinik II/Nephrologie und Klinische ImmunologieRWTH AachenAachenDeutschland

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