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Chronische Niereninsuffizienz

Was ist gesichert in der Therapie?

Chronic kidney disease

What is currently available for treatment?

An Erratum to this article was published on 02 May 2017

Zusammenfassung

Die chronische Niereninsuffizienz ist eine häufige Erkrankung. Deutschlandweit sind etwa 2 Mio. Menschen betroffen. In der Regel verläuft die chronische Niereninsuffizienz progredient. Bei Erreichen des terminalen Stadiums werden Dialyse oder Nierentransplantation notwendig. Typischerweise bleibt die Erkrankung über lange Zeit still und vom Patienten unbemerkt. Das ist gefährlich, da die Niereninsuffizienz bereits in den frühen Stadien mit einer steigenden Morbidität und Mortalität einhergeht. Umso wichtiger sind das möglichst frühe Erkennen der Niereninsuffizienz in der ärztlichen Praxis und die Einleitung von Maßnahmen, die die Progredienz verlangsamen bzw. die Begleitrisiken verbessern. In den letzten Jahren gab es diesbezüglich einige neue Erkenntnisse und therapeutische Prinzipienänderungen. Daher möchten wir aus nephrologischer Perspektive einen aktuellen Leitfaden für die Behandlung der chronischen Niereninsuffizienz geben. Dabei diskutieren wir, welche Untersuchungen für den Allgemeinarzt diagnostisch sinnvoll sind und ab wann der Patient zum Nephrologen überwiesen werden sollte. Pragmatisch beleuchten wir, welche Möglichkeiten des Nierenfunktionserhalts zur Verfügung stehen und wie sich die Gefahr von Begleiterkrankungen minimieren lässt.

Abstract

Chronic kidney disease is common in the general population with an estimated prevalence of roughly 2 million in Germany. Typically, chronic kidney disease is progressive and in the terminal stage the patients require dialysis or kidney transplantation. In many cases the disease remains silent for a long time but early stages are already associated with increasing morbidity and mortality. Therefore early detection is very important. In recent years several new concepts have been introduced that might help to slow the progression of chronic kidney disease or improve the accompanying risks. Here, we want to provide a nephrologist’s perspective on the current guidelines for the treatment and prevention of chronic kidney disease. We summarize which diagnostic approaches are useful for general practitioners and we take a pragmatic look at the existing opportunities for combating renal functional decline. We also shed light on established measures to minimize the risk of comorbidities.

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Correspondence to S. Fleig.

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Interessenkonflikt

S. Fleig, M. Patecki und R. Schmitt geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Ein Erratum zu diesem Beitrag ist unter http://dx.doi.org/10.1007/s00108-017-0238-8 zu finden.

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H. Haller, Hannover

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Fleig, S., Patecki, M. & Schmitt, R. Chronische Niereninsuffizienz. Internist 57, 1164–1171 (2016). https://doi.org/10.1007/s00108-016-0150-7

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Schlüsselwörter

  • Krankheitsprogression
  • Glomeruläre Filtrationsrate
  • Antihypertensiva
  • Diabetes mellitus
  • Influenzaimpfung

Keywords

  • Disease progression
  • Glomerular filtration rate
  • Antihypertensive agents
  • Diabetes mellitus
  • Vaccination, influenza