Nierenersatzverfahren: Information, Aufklärung, Dokumentation

Abstract

In renal replacement therapy, different methods are available: hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx). In addition, variants can be used: HD as a home HD or center HD, PD as a conventional PD or automated (cycler) PD, KTx as a potentially short-term predictable living donation or conventional donor kidney donation. The patient and his familiar or caring environment must be informed accordingly. This means first of all: information about which procedures of kidney replacement therapy are possible and can be offered. Then the specific risks associated with each procedure should be elucidated (e. g. HD and shunt bleeding, PD and peritonitis, KTx and infections/neoplasias). This necessarily includes a structured documentation of the educating center/doctor about the communicated information and decisions taken.

Nierenersatztherapien sind hochgradig technologisierte Verfahren mit komplexen Abläufen. Zudem sind sie meist auf einen längeren Zeitraum angelegt. Entsprechend groß ist der Informations-, Aufklärungs- und Dokumentationsaufwand. Dieser Beitrag stellt die verschiedenen Behandlungsverfahren mit ihren Vor- und Nachteilen kurz vor, gibt Hinweise zur Risikoaufklärung und erläutert abschließend juristische Aspekte der Aufklärung und Dokumentation.

Schlüsselwörter

Dialyse - spezielle Risiken - Aufklärung - Dokumentation

Key words

dialysis - specific risks - education - documentation

• Literatur

• 1 Tordoir JH, Kwan TS, Herman JM. et al. Primary and secondary access surgery for haemodialysis with the Brescia-Cimino fistula and the polytetrafluoroethylene (PTFE) graft. Neth J Surg 1983; 35: 8-12
• 2 Lottmann K, Klein S, Bless HH. Dialysis care in Germany – demand, outpatient care and challenges. MMW Fortschr Med 2015; 157: 22-27
• 3 Chaudhry RI, Golper TA. Automated cyclers used in peritoneal dialysis: technical aspects for the clinician. Med Devices (Auckl) 2015; 8: 95-102
• 4 Bevilacqua MU, Turnbull L, Saunders S. et al. Evaluation of a 12-Month Pilot of Long-Term and Temporary Assisted Peritoneal Dialysis. Perit Dial Int 2017; 37: 307-313
• 5 Schreiber Jr MJ. Changing Landscape for Peritoneal Dialysis: Optimizing Utilization. Semin Dial 2017; 30: 149-157
• 6 Bento C, Fuerbringer R, Tabisz A. Live or let die: when intermittent peritoneal dialysis is the only plausible solution for survival. Minerva Urol Nefrol 2016; 68: 45-46
• 7 Maggiore U, Budde K, Heemann U. et al. Long-term risks of kidney living donation: review and position paper by the ERA-EDTA DESCARTES working group. Nephrol Dial Transplant 2017; 32: 216-223
• 8 Lentine KL, Kasiske BL, Levey AS. et al. Summary of Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation 2017; 101: 1783-1792
• 9 Arze AL, Arze S. Preemptive Renal Transplantation-The Best Treatment Option for Terminal Chronic Renal Failure. Transplant Proc 2016; 48: 609-611
• 10 Bzoma B, Walerzak A, Debska-Slizien A. et al. Psychological Well-Being in Patients After Preemptive Kidney Transplantation. Transplant Proc 2016; 48: 1515-1518
• 11 Hellstrom VC, Enstrom Y, Zur-Muhlen B. et al. Malignancies in transplanted patients: Multidisciplinary evaluation and switch to mTOR inhibitors after kidney transplantation – experiences from a prospective, clinical, observational study. Acta Oncol 2016; 55: 774-781
• 12 Boissier R, Hevia V, Bruins HM. et al. The Risk of Tumour Recurrence in Patients Undergoing Renal Transplantation for End-stage Renal Disease after Previous Treatment for a Urological Cancer: A Systematic Review. Eur Urol 2018; 73: 94-108
• 13 Yu JZ, Rhee CM, Ferrey A. et al. There’s no place like home: 35-year patient survival on home hemodialysis. Semin Dial 2017;
• 14 Kraus MA, Fluck RJ, Weinhandl ED. et al. Intensive Hemodialysis and Health-Related Quality of Life. Am J Kidney Dis 2016; 68: S33-S42
• 15 Garg AX, Suri RS, Eggers P. et al. Patients receiving frequent hemodialysis have better health-related quality of life compared to patients receiving conventional hemodialysis. Kidney Int 2017; 91: 746-754
• 16 Wong B, Ravani P, Oliver MJ. et al. Comparison of Patient Survival Between Hemodialysis and Peritoneal Dialysis Among Patients Eligible for Both Modalities. Am J Kidney Dis 2018; 71 (03) 344-351 . doi:10.1053/j.ajkd.2017.08.028
• 17 Caicedo L, Delgado A, Caicedo LA. et al. Sclerosing Encapsulated Peritonitis: A devastating and infrequent disease complicating kidney transplantation, case report and literature review. Int J Surg Case Rep 2017; 33: 135-138