Pre-End-Stage Renal Disease(Pre-ESRD) Care in the U.S.A.
10.2185/jjrm.48.720
- VernacularTitle:米国における透析前腎不全医療の現状
- Author:
Shigeo TOMURA
;
Chiaki HIRANO
;
Hisako YANAGI
;
Tatsuo SHIIGAI
- Publication Type:Journal Article
- Keywords:
pre-end-stage renal disease (pre-ESRD) care;
chronic renal failure;
early intervention;
hypoalbuminemia;
anemia;
permanent vascular access;
dialysis therapy education
- From:Journal of the Japanese Association of Rural Medicine
2000;48(5):720-725
- CountryJapan
- Language:Japanese
-
Abstract:
A significant delay in identifying pre-ESRD patients is not infrequent in the U.S.A. because an early examination for proteinuria is not common, and renal disease is infrequently documented even when proteinuria and/or an elevated serum creatinine level have existed. Although there are accepted strategies for slowing the progression of renal disease such as the use of an angiotensin converting enzyme (ACE) inhibitor in diabetic patients or suboptimal blood pressure control in hypertensive patients, these strategies are seldom employed. It is also particularly alarming that the patients are often low in the overall health status, hypoalbumic, or anemic at dialysis initiation, and begin dialysis without permanent vascular access or without any education regarding dialysis therapy in many instances.
