HIV感染患者における透析医療の推進に関する調査  [in Japanese] Survey of dialysis facilities for HIV-infected dialysis patients  [in Japanese]

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Author(s)

    • 秋葉 隆 AKIBA Takashi
    • 東京女子医科大学腎臓病総合医療センター血液浄化療法科 Department of Blood Purification, Tokyo Women's Medical University

Abstract

エイズ感染患者の透析医療の確保に関して透析施設のHIV患者受け入れの現状を把握し今後の対策の資料とするため調査を行った.全国の透析施設3,802施設にアンケートを発送,1,552通(回収率40.82%)を得た.透析を必要とするHIV陽性者の透析受け入れの経験のある施設は94施設(6.2%),経験のない施設1,434施設(93.8%)で,平成23年11月現在のHIV患者透析実施患者数は89名(60施設,各施設1~7名,1.48±1.12名)だった.この施設は今後も「受け入れる」が69施設,「難しい」23施設で74.2%の施設が今後も受け入れを継続するとの意向を示された.受け入れの経験がない医療機関の今後の方針は「紹介があれば受け入れる方針である」227施設(15.7%),「今後,受け入れを検討する」445施設(30.7%),「受け入れることは難しい」776施設(53.6%)と約半数が今後の受け入れの可能性を表明した.しかしながら,「受け入れがたい理由」として,「HIV陽性者専用のベッドが確保できない.」「HIV陽性者への対応手順が整理されていない.」「透析中に急変した際のバックアップ体制が得られるのか心配」などの懸念が高頻度に示され,公的な援助なしに民間施設がHIV患者を受け入れるには多くの難関があることが明らかになった.

We investigated the present situation of dialysis facilities accepting HIV-infected endstage renal disease patients. We sent questionnaires to 3,802 Japanese dialysis facilities, and obtained 1,552 responses (40.82% recovery rate). Those which had experience of accepting HIV-infected dialysis patients were 94 facilites (6.2%), and 1,434 (93.8%) had no such experience. Eighty-nine HIV-infected patients were dialyzed in November, 2011 in Japan (60 facilities, range: 1~7 patients, 1.48±1.12 persons (mean±S. D.)). Sixty-nine of these (74.2%) answered yes to the question of whether they would continue to accept HIV-infected dialysis patients. In facilities with no experience of HIV-infected dialysis patient acceptance, 227 facilities (15.7%) would accept them if referred, and 445 facilities (30.7%) are preparing for acceptance from now on. A total of 776 facilities (53.6%) refused the future acceptance of HIV-infected dialysis patients. The reasons for being “hard to accept” were “the difficulties to prepare the dedicated bed and dialysis machines”, “the procedures for HIV-infected dialysis patients are not clearly organized”, and “back-up facilities for sudden changes in patients' conditions are not available”. We conclude that there are many difficulties for private sector facilities to accept HIV-infected dialysis patients due to the lack of public assistance.

Journal

  • Nihon Toseki Igakkai Zasshi

    Nihon Toseki Igakkai Zasshi 46(1), 111-118, 2013-01-28

    The Japanese Society for Dialysis Therapy

References:  5

Cited by:  1

Codes

  • NII Article ID (NAID)
    10031161736
  • NII NACSIS-CAT ID (NCID)
    AN10432053
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13403451
  • NDL Article ID
    024250778
  • NDL Call No.
    Z19-1413
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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