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Klug-entscheiden-Empfehlungen in der Nephrologie

Choosing wisely recommendations in nephrology

  • Schwerpunkt: Klug entscheiden
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Zusammenfassung

Die Deutsche Gesellschaft für Innere Medizin (DGIM) hat die Initiative Klug entscheiden ins Leben gerufen, um diagnostische und therapeutische Maßnahmen zu adressieren, die häufig nicht fachgerecht eingesetzt werden, sei es im Sinne einer Über-, Unter- oder Fehlversorgung. Die Deutsche Gesellschaft für Nephrologie (DGfN) unterstützt die Initiative nachdrücklich und hat fünf Positiv- und fünf Negativempfehlungen beigesteuert. Diese zehn Empfehlungen werden im vorliegenden Beitrag erörtert. Die Positivempfehlungen setzen einen Schwerpunkt auf die Früherkennung von Nierenerkrankungen mit einfachen Blut- und Urintests, den Einsatz von Röntgenkontrastmitteln bei eingeschränkter Nierenfunktion sowie die Problematik zu geringer Impfraten. Die Negativempfehlungen setzen mit drei Empfehlungen einen Schwerpunkt auf das Thema Flüssigkeitszufuhr und Diuretika. Die übrigen zwei Negativempfehlungen betreffen die Angioplastie bei Nierenarterienstenose und den unreflektierten Einsatz nichtsteroidaler Antiphlogistika.

Abstract

The German Society of Internal Medicine (“Deutsche Gesellschaft für Innere Medizin”, DGIM) founded the Choosing wisely initiative in order to address diagnostic and therapeutic procedures that are frequently inappropriately applied, whether this be in terms of over-, under-, or misuse of health services. The German Society of Nephrology (“Deutsche Gesellschaft für Nephrologie,” DGfN) strongly supports the initiative and has contributed five positive and five negative recommendations. These ten recommendations are discussed in the current publication. The positive recommendations reflect the importance of early recognition of renal disease via simple blood and urine tests, the use of radiocontrast media in cases of impaired renal function, as well as the problems associated with low vaccination rates. Three of the negative recommendations are focused on hydration and diuretics. The remaining two negative recommendations concern angioplasty in cases of renal artery stenosis and the unconsidered use of nonsteroidal anti-inflammatory drugs.

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Authors and Affiliations

  1. Klinik für Nephrologie und Dialyseverfahren, Klinikum Lüdenscheid, Paulmannshöher Str. 14, 58515, Lüdenscheid, Deutschland

    J. Galle

  2. Klinik für Nieren- und Hochdruckkrankheiten, rheumatologische und immunologische Erkrankungen (Medizinische Klinik II), Universitätsklinikum Aachen, AöR, Aachen, Deutschland

    J. Floege

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Correspondence to J. Galle.

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Interessenkonflikt

J. Galle und J. Floege geben an, dass kein Interessenkonflikt besteht.

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

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Redaktion

U.R. Fölsch, Kiel

M. Hallek, Köln

G. Hasenfuß, Göttingen

E. Märker-Hermann, Wiesbaden

C.C. Sieber, Nürnberg

Teile dieses Beitrags wurden bereits veröffentlicht in Galle J, Floege J (2016) Klug entscheiden … in der Nephrologie. Dtsch Arztebl 113(35–36)

J. Galle und J. Floege für die Deutsche Gesellschaft für Nephrologie (DGfN).

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Galle, J., Floege, J. Klug-entscheiden-Empfehlungen in der Nephrologie. Internist 58, 568–574 (2017). https://doi.org/10.1007/s00108-017-0248-6

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