Experience of once-a-week hemodialysis in an elderly patient initially refusing hemodialysis.

概要

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Once-a-week hemodialysis is increasingly used because it maintains residual renal function without a marked change in life habits. Hemodialysis was introduced once a week in an elderly patient who could not walk because of left hemiplegia, and who had previously refused hemodialysis. The patient was observed for one year. She was an 82-year-old woman who had trouble as an inpatient because of her egocentric personality. During the 3-year course, urine volume was maintained but renal failure gradually exacerbated. Although she initially refused hemodialysis, she was persuaded to receive it once a week. Since she could not record them herself, her helper was instructed to record water intake, food intake, urine volume and somatic symptoms, and guidance was given to the patient by the doctor in charge on every hemodialysis day. Up until her sudden death due to acute myocardial infarction one year later, the patient had no severe complications and could continue to undergo hemodialysis without marked changes in her life style or her family's social life. This experience suggests that this therapeutic method is effective when good cooperation with family members can be obtained, and carefully thought-out instructions are given, even if the patient is elderly.
社団法人日本透析医学会の論文