CAJ | 학술논문

老年慢性肾衰竭（CRF）起病隐匿、表现不典型、进展缓慢，容易误诊、漏诊或延误诊断。目前尚无有力证据证明哪一种估算肾小球滤过率（eGFR）的计算公式更适合用于老年 CRF 患者肾功能的评价。血清胱抑素 C（Cys C）是近年提出的一项新的 eGFR 检测指标，对于 Cys C 在评价肾功能方面是否优于血清肌酐（Scr）值，特别是应用于老年人群，还需要更多的相关研究证实。老年人 CRF的保守治疗包括：注意找出肾功能恶化的可逆因素，治疗伴随存在的其他系统性疾病，个体化实施低蛋白饮食，根据病情决定是否需限盐、限水，控制高血压，延缓慢性肾脏病（CKD）进展和心血管疾病的发生等；透析治疗是否可以有效改善老年 CKD 患者的预后，目前仅有观察性研究的结果，结论尚有争议；年龄本身不作为肾移植的禁忌条件，研究表明肾移植可以延长患者的生存时间和提高患者的生活质量。但由于老年人群的特殊性，肾移植前各方面情况的评估应更为谨慎。
노년만성신쇠갈（CRF）기병은닉、표현불전형、진전완만，용역오진、루진혹연오진단。목전상무유력증거증명나일충고산신소구려과솔（eGFR）적계산공식경괄합용우노년 CRF 환자신공능적평개。혈청광억소 C（Cys C）시근년제출적일항신적 eGFR 검측지표，대우 Cys C 재평개신공능방면시부우우혈청기항（Scr）치，특별시응용우노년인군，환수요경다적상관연구증실。노년인 CRF적보수치료포괄：주의조출신공능악화적가역인소，치료반수존재적기타계통성질병，개체화실시저단백음식，근거병정결정시부수한염、한수，공제고혈압，연완만성신장병（CKD）진전화심혈관질병적발생등；투석치료시부가이유효개선노년 CKD 환자적예후，목전부유관찰성연구적결과，결론상유쟁의；년령본신불작위신이식적금기조건，연구표명신이식가이연장환자적생존시간화제고환자적생활질량。단유우노년인군적특수성，신이식전각방면정황적평고응경위근신。
Chronic renal failure (CRF ) in elderly patients has insidious onset, atypical manifestation,and slow progression,which is prone to misdiagnosis,missed diagnosis,or delayed diagnosis. There is currently no convincing evidence that a certain estimated glomerular filtration rate (eGFR)formula is more suitable for the evaluation of renal function in elderly patients with CRF.Serum cystatin C (Cys C) is a recently-introduced new detection for eGFR.Whether Cys C is superior to serum creatinine (Scr)in assessing renal function of especially the elderly,still needs more related studies.The conservative treatment for the elderly CRF should include finding out the reversible factors for kidney function deterioration, performing treatment for other systems′diseases,implementing individualized low protein diet,limiting salt or water intake according to the disease condition,controlling hypertension,and delaying chronic kidney disease (CKD)progression and cardiovascular disease occurrence;whether dialysis treatment can effectively improve prognosis of elderly CKD patients is still controversial,because currently there are only results of observational researches;and age itself is not a taboo condition for kidney transplantation.Studies have shown that kidney transplant can prolong the survival time and improve the quality of life of patients.Due to the particularity of kidney transplantation in the elderly,the assessment on all the aspects should be more cautious before the kidney transplantation.