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Vorbereitung und Beginn der Hämodialysebehandlung

Preparation and initiation of hemodiaysis treatment

  • Leitthema
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Der Nephrologe Aims and scope

Zusammenfassung

Im Rahmen der Entscheidung über die Wahl des Nierenersatzverfahrens ist eine umfassende Aufklärung des Patienten notwendig. Dies führt zu sichereren Entscheidungen und senkt die Mortalität. Eine besondere Herausforderung stellen Patienten dar, die ungeplant dialysepflichtig werden. Hier sind Konzepte zur Ad-hoc-Lösung und zur weiteren Versorgung notwendig. Getunnelte zentralvenöse Katheter als Dauerlösung sind für einige wenige Patienten gut. Der Beginn der Dialysetherapie sollte bei klinischen Symptomen oder medikamentös nicht mehr beherrschbaren Problemen erfolgen. Ein frühzeitiger Dialysebeginn ist weder bei mittelalten Erwachsenen noch bei geriatrischen Patienten von Vorteil. Die Sonographie hilft zur Beurteilung der Shuntreifung und im Rahmen der Erstpunktion. Geeignete Schulungskonzepte, auch für das pflegerische Personal, sind zu entwickeln.

Abstract

For the decision on the selection of the kidney replacement procedure, a comprehensive enlightenment of the patient is necessary. This leads to safer decisions and reduces the mortality. Patients for whom dialysis becomes unexpectedly necessary represent a special challenge. In these cases concepts for ad hoc solutions and for the further treatment are necessary. Tunnelled central venous catheters as a permanent solution are only good for a few patients. Initiation of dialysis treatment should be carried out when there are clinical symptoms or for problems that can no longer be overcome by medication. An early initiation of dialysis has no advantages for either middle-aged adults or geriatric patients. Sonography can be of help for assessment of shunt maturation and for the first puncture. Suitable schooling concepts need to be developed, even for nursing personnel.

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Authors and Affiliations

  1. Innere Medizin II – Nephrologie, Rheumatologie, Intensivmedizin, KfH Nierenzentrum Bottrop, Knappschaftskrankenhaus Bottrop, Osterfelderstraße 155a, 46242, Bottrop, Deutschland

    M. Hollenbeck, O. Deeva & M. Christen

  2. Gefäßchirurgische Klinik, Knappschaftskrankenhaus Bottrop, Bottrop, Deutschland

    H. Pilevhar & G. Wozniak

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  1. M. Hollenbeck
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  2. O. Deeva
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  3. M. Christen
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  4. H. Pilevhar
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  5. G. Wozniak
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Correspondence to M. Hollenbeck.

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Interessenkonflikt

M. Hollenbeck, O. Deeva, M. Christen, H. Pilevhar und G. Wozniak geben an, dass kein Interessenkonflikt besteht.

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

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U. Heemann, München

J. Lutz, Koblenz

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Hollenbeck, M., Deeva, O., Christen, M. et al. Vorbereitung und Beginn der Hämodialysebehandlung. Nephrologe 13, 382–388 (2018). https://doi.org/10.1007/s11560-018-0287-6

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  • DOI: https://doi.org/10.1007/s11560-018-0287-6

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