ATTITUDES OF CAREGIVERS TO MANAGEMENT OF END-STAGE RENAL DISEASE IN INFANTS

作者：Teh Jun Chuan; Frieling Michelle L; Sienna Julianna L; Geary Denis F^*

来源：Peritoneal Dialysis International, 2011, 31(4): 459-465.

DOI：10.3747/pdi.2009.00265

• Chronic kidney disease
• renal replacement therapy
• ethics
• infants
• withholding or withdrawal of treatment

Objectives: To characterize the attitudes of pediatric nephrologists caring for infants with end-stage renal disease (ESRD) compared with attitudes from a survey published in 1998. Nephrology nurses and social workers were included.
Methods: An e-mail survey was distributed to pediatric nephrology teams in Canada, Germany, Japan, the United Kingdom, and the United States.
Results: Survey responders totaled 270. Renal replacement therapy (RRT) is offered by all nephrologists to some children 1 - 12 months, and by 98% to some less than 1 month of age (93% in 1998). Of responding nephrologists, 30% offer RRT to all children less than 1 month of age (41% in 1998), and 50%, to all children 1 - 12 months. Among respondents, 50% indicated that parents can never refuse RRT for children aged 1 - 12 months, compared with 27% for younger infants. The most influential factor in rejecting RRT for infants was the presence of a co-existing abnormality. Nurses were more likely to believe that parents have the right to refuse RRT for infants.
Conclusions: Attitudes of pediatric nephrologists have changed since 1998. Also, nurses have opinions that are different from those of the nephrologists on some issues, and a consensus should be reached before speaking to families.

• 出版日期2011-8