{"created":"2021-03-01T06:13:50.746041+00:00","id":9751,"links":{},"metadata":{"_buckets":{"deposit":"cf1529ed-5eb6-4d64-ab12-76b2788b45f9"},"_deposit":{"id":"9751","owners":[],"pid":{"revision_id":0,"type":"depid","value":"9751"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00009751","sets":["453:456","471:537:538:945"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Approach to CKD (Cooperation in Medical Management of Chronic Kidney Disease)"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2012-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"132","bibliographicPageStart":"129","bibliographicVolumeNumber":"126","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌"},{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"外来通院患者100名の推算糸球体濾過量 (eGFR) を求め, 慢性腎臓病 (CKD) の頻度, 基礎疾患, 合併症等について検討し, 典型的な経過を取った症例の特徴や問題点を提示し, CKDや腎不全患者を専門医に紹介する時期や病診連携の在り方について考察した. 対象患者のCKDステージ2は31%, ステージ3が61%, ステージ4～5が8%で, ステージの進行した患者が多く, 日本人成人のCKD推計値 (ステージ3以上: 18.7%) と比較しても, CKDの頻度は非常に高率であった. 対象患者の平均年齢が69.4歳と高く, 2/3が女性であり, 実際のGFRが過小評価され, さらに多くの症例が基礎疾患として糸球体硬化を来たし易い高血圧や糖尿病を有するために, CKDの頻度が高くなっていると考えられた. 血圧や血糖のコントロールが困難で, CKDが急速に進行悪化する症例は, 腎専門外来に早目に紹介することが必要であり, 進行の緩徐なIgA腎症等の慢性腎炎の管理は, 病院と診療所が連携して患者のQOLの維持や治療費の自己負担軽減に配慮すべきである. 精神病を合併するような腎不全症例でも, 精神病診療が可能な地域中核病院の腎臓病専門外来との病診連携が重要で, 持続携行式腹膜透析 (CAPD) による腎不全の治療により統合失調症が軽快した興味ある症例も経験した. CKDの各ステージの診療においても, 患者の診療情報を双方向で共有しながら行う併診を基礎として, 効率的で緊密な病診連携を進めていくことが求められる.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"67416","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Nagai, Akihiko"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00290440","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"永井, 明彦"}],"nameIdentifiers":[{"nameIdentifier":"67415","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-06"}],"displaytype":"detail","filename":"126(3)_129-132.pdf","filesize":[{"value":"465.0 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"126(3)_129-132.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/9751/files/126(3)_129-132.pdf"},"version_id":"5693b0da-1829-4743-a2a4-e37db1f34eb5"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"高齢者のCKD","subitem_subject_scheme":"Other"},{"subitem_subject":"病診連携","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"4 CKDへの対応(慢性腎臓病 (CKD) の医療連携,第655回新潟医学会)","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"4 CKDへの対応(慢性腎臓病 (CKD) の医療連携,第655回新潟医学会)"},{"subitem_title":"4 CKDへの対応(慢性腎臓病 (CKD) の医療連携,第655回新潟医学会)","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","945"],"pubdate":{"attribute_name":"公開日","attribute_value":"2015-01-09"},"publish_date":"2015-01-09","publish_status":"0","recid":"9751","relation_version_is_last":true,"title":["4 CKDへの対応(慢性腎臓病 (CKD) の医療連携,第655回新潟医学会)"],"weko_creator_id":"1","weko_shared_id":null},"updated":"2022-12-15T03:43:42.891089+00:00"}