腎臟病人的臨床預後以及功能評估

Evaluations of Clinical Prognosis and Functional Status of Patients With Kidney Disease

陳怡汝(Yi-Ju Chen) ； 熊育敏(Yu-Min Hsiung) ； 賴俊夫(Chun-Fu Lai) ； 陳永銘(Yung-Ming Chen)

《腎臟與透析》 34卷1期 (2022/03) Pp. 1-6

https://doi.org/10.6340/KD.202203_34(1).0001

摘要

許多包含腎臟病在內的非癌症疾病的末期病人也有安寧緩和醫療的需求，這些病人的生命末期不易判斷，需借助預後和功能的評估。本文回顧了近年國際常用針對腎臟病人的各種預後評估工具，對短期死亡率評估具可靠效力。功能評估則包括巴氏量表（Barthel index）、美國東岸癌症臨床研究合作組織（Eastern Cooperative Oncology Group, ECOG）評估量表及Karnofsky功能狀態評分表等。臺灣本土也提出經實證的整合評估工具，亦有數位化的程式可使用。醫護團隊應善加應用以掌握病人的整體情況、評估長短期預後及安寧緩和需求，給予合乎以病人為中心的醫療照護。

關鍵字

腎臟病人 ； 臨床預後 ； 功能評估

並列摘要

Many non-cancer patients with advanced organ dysfunction may also require palliative care, including those who have kidney disease. In order to identify the end-of-life status, we need clinical tools to evaluate the prognosis and functional status of patients with kidney disease and end-stage kidney disease. We review the use of many prognoses prediction tools that have been verified to be reliable for predicting short-term mortality. The Barthel index, the Eastern Cooperative Oncology Group (ECOG) evaluation scale, and the Karnofsky Performance Scale are useful tools for evaluating patients' functional status. We also recommend validated assessment tools developed in Taiwan. Modern life technology has made online and/or mobile tools available. In order to provide patient-centered medical care, medical care providers should know how to use appropriate tools to grasp the patient's overall condition, assess the long- and short-term prognosis, and assess the need for palliative care.

並列關鍵字

kidney disease ； prognosis ； functional status