Anexa & . ‘hl de eobtare gl nerwrRoDUCERE Paint cu baal cronies enala (BCR) dc o via pefund snr 1h Inala de probleme datrte bl organice (popes opt tik apariacomosbidiaiiorspeeifce BCR ~ ane, HTA. boas ‘crido-asculr maui bola ous eal dsiidel ai ‘za metab}, pace atin de inodacee trp de Subst a finer reale(TSFR) sunt super presiunt ex- {eme compartileeu cle cre aconeaza si arupa sor pace ca oad conics (reiti aliments, Ahrvlectoilia, comm de rmocament,efcse bol sg lee mule Independents, Sera de vi al social, servi, unt sexual aerate plan Alc de vio nesigures, aftr imagining). Ce. fare efecuraz bemodiliz,dazapentoneaa conta lle sou ‘liz prionca imeritens nocumd preci in aot eu masa ‘dependent eh precedent in istariateboloie! mes. Ca io ‘a pen liza peroneal com na amtylaorie st pa ut ‘ual ireadian rept alschinbari sour de ale. Toi a= piel sun grav dependent e o procedra motizal 9 de an up personal median genera, pneu pshoogi ni ananit pacient la boat va depnde de personaliateapremartda a acest, veal suporafu fami sei eval bl food Obiecivele Watamenult inufelene rele eovce termine (ARC sn grape prezet pe doud mar rei: deren meri ‘mona eresteen cla vet ball: Date despre orb. Imonaliste sestel cates de pace feo imagine incompetsupra efi actu media, In conde Jo ere conceptl de ratagenent al bol rele cronice et fn plind denote, ace coin co compere ceil peice em Sarai prop, Aces po tee w bol eres prt vind maximize cali ve devine on scopes ing medial In acest ceatext, evalua call vei paien- Ilr uremic, pin insrumente specie,» devenit 2 element inds- persabil in demonsare feel intervenor teapeutce. Priholgol poste interven ining pace cu BCR Ie mal multe velar educa coallerea (cca, impeunt.ev terse tia medical conriuie a reablitrea acest, evalurea saber ‘area modifier psbo-comporamesale,evaisree peroded 2 ‘all vi Dae uele din cet interven pesupan muna in ‘chp prin intermedi une echipe de igre mokiiseplinare ca ‘re itervine prin programe complexe de reali nate inte enya psthologlu este Invi: inulin inal sceten vi zeal seadrea costo necesare nr acestor pacien‘GRADE DE RECOMANDARE dapat dupa US. Prventive Serices Tank Force (1996) Grads chip de exper recomandd cx trie aplearea de ruin. incr nifecomandi I pacing instotnnefecomandae de [ral "A" necator nor dover conver ape ‘eiaeedora aelireai un prognostic medial important #8 po- ‘ania beef depses substi pile eat dyes). Grad Echipa de expe recomandi aplcac Ge nt a iastctuiveco- andi pacint eligbil (0 isiriunelecomandare de grad "nd exsontaunor dover renal & pla ae cesta amelloreazt un progneste medal impor spon cle benefice deptgese potential fst advers), Grd chip de exe reeomandi apicarc de run instruc. ‘mandi la pace eligf fo isvuefuntecomandare de rod "C™ ‘inet exitena uni cones re exper in sensu apie acest stor dare dover ed aces insrucfuneecomandar esi) ‘iene lpr, ent de calle nde au condor sa ‘chia dite poteflle bere poe fet adverse ‘poate Fi Stemi eka prin ania dover existe Gradol D chip de expe contrainie eplcarea de vt aestrciunie- ‘comands (osnctioneecomandare de gad "Din et pln txiena woor doves! ezaable cb epics scetifacestra ete Ineficent sau eb potefill eicte adverse deptgesepotelle beni, chip de expert concuoneaa 8 dovecile su insoiciente pe Fecomantdarea poeta o instusurarecamandae de gad "nied fap doves aceasta insrcjinetecomandar este (sunt) ficient) pss, sunt de cltateIdoinica sau contaie- ‘ort sau ed eli dine potenflle beef si potefilele ect adverse nu pote determina, far expert a jus Ia ‘bine ul contr in Scop ecamandai cestialcestoal.|. Recomandari de psinologica la paci fe rinichi litare gi interventie ‘cu boala cronica‘Paclntl cu tool roi renal inne de itzedscorn era tue afunior rene Recaandae “Tnierelanetog rei tn conieraiestne cn Fete -<60 mL nt 73 met oblgtrieatnc cind FG ese sib <0 ‘mLinin73n? sau sure eld eetnina see a rset la Sg ‘ae its 20 mo/dL a rb indiferem deci saun ae “nde ole ball repaleeronie cum af potiuria (GradulB) Recomandar 2 ‘Sirti tenet in zl paielor cu FG <60 mini 73m? ‘cba cron ate SSfecomandare 22, Reducores moral gh mde Tepe de BRC. In general ccast se rear) i cela {cy abordarea anemic real, uit, homeosazilor es eter ni reales eee 5 Reowmandare 2, intrirea sou preverires progress insfeienjel renal, Aceasa va include uataneril bolt re de fond, masureasistematc a FG a prinrch In sop rei epi cotroll ait al presen ane Fak, nhl’ de ECA Ta pacient eu dabet ras sau probimule >3 pa, coool sre l gleam gol fara actorilor de ise (ncasiv fumatd, sowalile Tpke, apo axesvdeprotine. (Grad) Reowandare 2. Pent implementarca acest epi. triniterea la neftolg ese obligate (Gradul C) Rocomandae 3 ‘Pacienficu FG <0 rani .73 2 sede until renal in poe ‘da tera rebut sb ng jreaura neiolog sip lt perry deus rele termine. Ace pe fel os Recmandare 3a Alegere cele mi deca lca (Sox tity nual) 9 slat ma acate forme de nt met (de ex. HD, DPCA, traysplan say amet comes top, Acta algere va implica dscua pad, ani- lin sess ehipanfilogic, Aces proces poate neces. 1a implcarcaunoe corset special Ta aaa realluc sciai. (Grad ©) + Reconandae 3b. Preitren unui acces de alia de © ma~ er eroologieadevas (Gradul B) + Recomandare 3 Lutea In considerate vaccine ant- Iepatties; efile acesela tebuie evaluate repuat (Gradul ©, + Recomandive I tunel clnd FG a sczutsub ISeL/nin? 1 Fn, eva trees nto Rete la ier de ha ‘a, custentiespeiaiiaconraul HA, space vo- lemiceianomalilor bachimice si tatare maloutriiel (Gradul ©, Recomandare Le lvl lnc de nfo, in abordares pace a eb Implicit oechipd uli pinars contin in afr de mec ne folog i astentele medias, din: fakinetoterapes fmt cl rie; tet: specials in teapie oopaional; err socal eu ‘lie ecunosua glu experi in olile rene chip de n- _gije medial la vel primar chip de ingrjte neal I ivel Secundar (tne cnd este ncesan oorénater de wasps tentde ltrs psitolog cine afcare ecunosa sau expe- rien nb renal, (Gradul C) Resomandare 5. In ena in cre paclentl ae un FG 30 mii. m2, tac te ble a primensch edie structural pelvitore a pees ptr ‘TSFR (radu ©), ~ Recomundare Sa. Eduila structs sstnatichprecce privitoaef BCR gi TSER ameioreaa stax pace aig comlina areata la consttngele medcle impos: 4eBCR gi TSFR, compara uasitenga meals standard actual. (Gradal ~_ Recomandae sb Progamele medicle strate, epee de IMD $insrctr speialzeducd pico mal Dine ompaa eu iastveto on-peclizt (Grad = Recomandae Se. Educatapivitoue la BCR gi TSFR se oreeal ret u rere ssa pont, compli- anja atrumment i prognosticulpciewulut (Gradal 1Recomande 6 Tn coz in care pcientl ae un FG <30 mLimi.73 m? fo ete shguat ron program regu de enereffi fee, ure tebule 38 Fisedaat, cost nur sop res activi fice. In iz ce pce ee neapi de ante tebe De 38 (Graal B Recomandare 6, Exit o earl diet inte foeia 2 let progrosicalpaceniee ca BCR ata tn pre-TSFR, (Gradat = Recopandare 6h Edu, cones ner sen- sul feta exercilor Mice determin amefiorce eet ii Rieke astornporate, 2 perlormane ice marble fia copii de eo. (Gradal 1), = Recomandre 6. ua conser inure in sen. sol eect! exciton fie se cordean det cu ae Nore prognotculsimedcl compara cu pacieni cre rsbeneiara de sere. (Graal 1) = Recomndare 6d Exerc Mite supeavegheat amelie prognesical compara cu pacleni are nu beeficaa de cesta (Gradal 1) ecomandar 7. Inenzl incre pacienlare un FO <30 rami. 79 2, tee bie ineunjat sp menos eviaten pofesiomala 8 pieases cone voeaonaa per idenicweeprefrinor. (Grad 1 Recorandare To, Conse profesional la pen co [BCR preTSFR amelioveazl mesineres profs in impul "TSFR. (Gradul 1) Evalue cline individu sistemas ametionac prognos cil pacer ev BCR pre-TSFR comparative sistema ual ex ‘actriz prin evar so-so reabltares on-ndiviua ‘ia (Grad Recomandar 9 Evia earl ine suport emotion! prognostic paleilor cu BCR pre-TSFR (GrdResomandare 10. ‘Depreda anxeses i otiates abu ieniete raat pe lem cu BCR pe-TSFR. (GradalB) Recomtandare 1a. Tf pace cu BCR pe-TSFR rebuie ‘alu de piolog in moment diagnostcu sl periodic thei, petra evahre tri pioloce a pacer foci specie pe prezn depres. nse ete ‘i. (Gradal Q. + Recomandare 105. Pacem ebue trata penir depres, nae estitate or dete o prez una dine aces {estar pslolgice. (Gradul C) Recomendar (Orie pcient eu BR rebule 8s eparizee un lertor socal ‘Acta oat eolva le dire problemele pint etm arf dea, transport suport (Grad Evalue cali vei prin nsrumente sandardzse webs ec- ‘ual tune end FG ete sub <20 mLlmin/ 73m au stn ln creating seri a csc la 1S mg feel a 2.0 mg a babu (Gradal Paleo Bal rnd rn ‘ae neil rae Recomandae 13. “Tol pie ilo tebuic consiia ner regu de re échipa de IMD pent ertres niveau de ative fk. (Grae aul) ~ Recomandae [Sa Petru abordreaadeva a pacenor (de expen fokineoterape sau reabliure cares), ble demifeaeproblemele cractrsice a settora(ota- pedice/usculo-sebleice, cerdiowasclare tau mot “ationae) (Gradul C) Recomandr Masurarea fel fee: Recomendar Ids Evehrea fei fic gi reevaiares roramalu de activate fia tru feta cl pin faa a6 luni (Gradul ©) pl inroducerea teal de substRecomandare 4b, Feta iid pote marth prin teste sau chestonare (de ex. SF-36) de pecan fe. (Gardul © Revemandare Me. La facarepacient,trebe idee polenflele taere de pariepare Ia asnaile fee (Gradul Recomndate IS, Recor de stv Fic Tecomendare [sm Mu pace dain set everdecon ion de acca, acea pot nace Mankinceirapie ‘ry ere fore reste pln la momen in {ne vor feos electoze nivel de eit Ra- fet recomant, ‘Recomsndar Sa Pali care neces ear cr acs iri erie ce un speci. (radu C) “+ Recomandare Ii Tina de acti ible ie wn ellis fae deintenstate madera de 30 minut in maori (peferabil oat) zor saps, Pie aren sun scunimente civ din punt de vedere Bake trbul st nceap I vel dust fore joase 8 brogresze In tod gradat pind ln nvell recomandat (Gradat ©) Resomandae 5b, Ui + Recorandae 136i, Evaluaea fe fe nerjoren pon pricpare latvia ale bul ad par- te de rid din plano de ingires paceslu Reeva- Tare period eh rebue sf includ evakarea modi. lo de evs fete Ge. (Gradal ©) ecomansare 16. ‘Top pain lina webue consi near aod regular Ingerap famatl. (Grado A) Se recomend ingea fon spe ils frerapeca fama. (Grad C) Recomandare 16. O ate sped tebuieacord pci- clr depimai cy capctate mice angle activate Fac. (Gradal C) Recomsndir 17. Depressi ostiitatea webu Wemifcate trate la pa- 10clea ilo (Gradual B) Recomandsre 7, Toi pacleni lint tebe examina epsiolee sun lertir socal I ines aia i cl ‘pt a6 ln teri, peau evaluate stl piologice = acenlcufoclzare pe Menifearea depres, ans a ost. (radu C) + Recomandire 17b. Pacem dizi wéule ta de depres, snilte si oniliste ch prez aceste sti plolgice (Gradal ©) Recomandre 18 Pace eu FG <0 mLmi.13 mre fe geriodc vaua peri indict cali vepi (Salus funjonal i sure de bin) (Gra » per sails niveau de ects montoriarea mod Fete apirt in imp:(Gradal B) pent evaire ef intervenor aspea satu veil is tri de bine. (Gradat B) 1"Il. Pagientul eu boala croniod de Fini ie de introducerea terapilor de substitufie a funcfiior renale‘TRINTEREA PRECOCE CATRE CLINICADE NEFROLOBIE' ‘ala trata Ese car factor eae infvnteazt orbit # morale sce iz peels operiadindelanga aes saat {erminal de oal, ind necesita TSFR ese iinet. Dip eteric- re ota pci (20259) sunt lute evden de un stiles ‘naht de nceperes dale; acensi deyi programele medial sete ale reeunose importa impli precoe i conte a ue chip Imut-lsciplinae spciizte pena paint res In ingrjiea se bincconceat ch implcre ree a wefolog se asocia cs rumeroase proghosice negative43607,Acesea sin reprezetae ‘er acelerenpogrese toll enale,progrsa comorbdialor (Goemis, HTA, boas cardioasculr,malmai,bai oss ral. disiphemile ridoza metabolic). De asemonea,famatlg ‘onolu Inadevat al glcemi! ls pci abet vor inna ‘motbidiates gl monaiate consecutive. CConecingl impli ira nefolgul st diza de urgent. ‘umorbidiate smocaltate mar ulna iadeevat a fenduilor eal. Dialiaa de ugensimpleesrtasupes moll de alegere tial’ de TSFR, pen perc eapcitates dea refine wn abort ‘vascular de dort, impiedicdprelireapshologid a pacienlat ‘eu samen spun sptalzarea poten pent un com ples paologie uneat grav: Moralaten in acest Siti de erik owe angela 259% Evin numeroase exemple in erature igri suboptimalt 2 [BCR oferts de mel do medina primar inane ier ne- Aologll, su eae pede tape, demenstrewace grea re lithe cre nfrlogi este superior, Exist un cose in co- ‘muntatanefologea pvr le avantjle In evident precce de catenefoog! 80, {Consecat consersu ne expe, nsraunile de mai jor sunt cexinse sl dapate dia, European Best Proce Guldelns for Hlamedats (Par 1) 8ow4PA MULT. DISCPLINARA DE ADROARE ‘alas rata Exist mut mal pti consnspivito I tl incre ebueacodo 18 ng pace eu BCR in era in eae fst real lures in evan presoee.Igrlivea reali deo ehipt mulisipinars (UMD) nu esto ide nut ng susinat net del nepal aor 90. Cu tate acestea, pind in pe zeta fost suit oer marginal Sou relate inconsante€.8, Top ee, 0 Seve de sul Sutdomonstat 8 IMD est supeiour in al multe pvt ng andard realize unsingirneffolo: al important, acess a econ omar amelorre a sopra dupa iiren de alae, xl amallorra cat viel pacer liza ines {il IMD preci? 18Problene de inplementare xt probabil dua princi aie nf iil pe scar at ‘8 modehi IMD. In elma id, si nefolog! nu asap daca ‘model exe supeir port a ngejines Ws pet teast ae tude se tne la ace neffolog sh etror patenf formed _Bropul econo! din stile [16] [17] Aces date Roi demon. e78 Sn wemenen mod eens tec bandit eee ‘ad, in mute siti, Fondue exsene st isu pent 8 ‘port infastctura spaie wi salrizare echipe! de IMD. snd. © indispenibil sa incompleh, Cu ote yee, ese prob etn ea prin chips de IMD va putea in cuad sb demnsteze costeicena pin ameiortea prognostceley,incsiv irre ebuild ESRD, creeron liza tll aneiovenoase cere spicai unr modaliide dali Ia domi ma ietine. sede, hut eatastrofe al ESRD ex wilzare neni ester ne tea spitasa i, ponte, prin edverea rater despa dup ‘ceperea ds nsh,domenilaalizeleconomice 4 BCR etic Ia nepal sale. Din fer, dovece alse 6 saile at ‘usmenonate vor sul in evearen condor care vor eons Ia ‘hipaa creer clinic economies vox promove coe ctu de MD (a rafune pon ineunjare expersunl bors prin IMD ee Sap ednceasa oer oporuiySemnieative penny dagmntc si atamenad mare mde de paclon ou BCR now refer? fk SupalneReares resrsor lili ale reffloge caren 9) rk {rexerea masa pool In arent privet se ot deevola mo dle de dbus ingielicte medic de ami intern et fn mod snap lane considera svete poms mode de IMD care nu neces evalure dete nefolg la fete iz, pot prin wilzarea woe Nc Ing, lpr mpl cor uno sistent medal specalinte su reciente 6REABILTAREA PACIENTLOR CU BCR PRETSFR etn Aces capitol al hid se rfet I ebiltare wliaest termi oogi, ani oganiajilornetoogies, imps de Lie Options Rehabilitation Advisory Comet? Resblitoes, care poste sh nla su rw mento citi po fesonle, este deft ca etaare vel aero de Functions re. Reabitaren presuune ca pacintul st fle expbil sb realzee ceca ce este necesar ctv atiiee) ceca ce drele 8 ele ‘Life Onions Rehabilitation Advisory Come dese Spnpt une ‘damental se programuls de veailiare per pce eu toa ral terminal Ledvcafseonsiere 2Exeriu fie 5.Conslereccazionaas prtesionala “bala indviduaiat| Sncurjare suport emotional) cast sejune ashi est subimpiit in cape cre coree- pnd acestrS suet, 7suc eonsere Poca cu BCR pre-TSFR se aft fn fata unor desi importante privioae lava lor uleioar, i special I TSFR pe exe 0 vor ecu Alegeren ete ish het tamentele su compete, Inpacing restr slipenae si Md, scheme medierentase, sre unui aces peioneal au vacua, eventual wanspant.Pro= frame de educate pre-TSFR se venech aeseor! nu Cor ere Feformareapaicnul supra taro metodeorerapeutice ci i pein o ra ai mare de mortal. Autor ex- ied retale sind eb prezena IRCT gi dain reprein wn ‘Sesor mai pte, ma stetiy, peau fail rg gre- ie ‘Suprtl socal a fost soit a pcinilhemodlliza cao mal bunt ‘compliant I amet, Pein ex un suport femal bon Drea ogre fterlics ma scau veut mal bela ese de atrator pena fsfor pots nine, un sma mare ‘ent itconplians a regimulalimentar(exeima pia hiperoste Femi) sa oserva in earl acon hemodializi care heuise sing ‘A a pocienit incien it la cel prevalen suport sal pe ‘it in pare pterilor sa creat poz eu veal bet-rdor ‘elr culate inves cu inerlekina-12(IL-12)- medio new oendoctini soi ci snrtaen, crea ce sgereazh rl ini preeniorinevoluapacienglorhemodiia ena vc, alia pate fo sus de upon Socal, drs de sires In poplin general, peseanele nemulaite de soi de- ‘lar lau stare de stttate mal pout emparatv cael cre a ‘Soil ete so cei dvor™ In eau near nal dine sot uf de otal ried olen fale se sehinb radi par complica care afeteaza diet rai ines reco depres ‘elie, polomete de nats srl in eis red pi Fear nol dite so sures de IRCT a aria 80 propor de 50% secluau difcuay marta. In panjcalar, dow fe Teele cu RCT, confetl i cupls (combina fcu exists uel fai umerese) te asec ator neurdendoer gl imunolgil™,rec ct mortalistea. Explai ar lep deesponssiisile ‘umerease ale fenelo, de rene economic limite den ‘port rei! ms ssn Incaul elo efi umerate qa ‘mulgenerationle!™® De asemenes, sui snerioare a rt oi ‘mace leven a sinptomelr depesve ga prceslriflamatoi Ja femelle alate program de hemodializa ‘Modul in cae rel pesealula modes eu pcientl il ine ese even acesin din urd ete isnt studlat. Dtle eset ara satisfac paren a eat ca mod in ere ste ingrid nfoogi assent tehnicien! ve eorlezhposty ‘nivel alumine serie. O asacee sa observa ex 0 compl- ‘nt comporamenal albu polenta (espectaen nani Si. urate yedinilor de dali preserise de medic). dar pamal te azul une reli stistetoare cu medical de dia CConclzi/Recomandiri Peep sport soil est ascit ey compan a tratment si ¢ moraliatea pacer hemodialza. in acs ses, suprtl oc- al exe un element ear niu ons din eval ects de Palbolesi din centele de daz. Aceqtin depo de meted ie de consi fara, mente st ameloreze reali fal Sunt ne acotredomers pei valdare le pola bemodie za unorcesianae destnateexlsiv evalu suport soe al In preent este dsponiid In car chesionanlul KDQOL. SFTMo seal de eveluare a sas! pint diz! eas FUMATUL ‘Analiza erates Fmatljigarteor este universal recunoscut ce ator de is nde- ‘pendent a ol cardio-vascular. In onseci,fma bul des. Curt latf pacien eu BCR. Aces recamandare est nc ptericsistnod de eli dine una progostialinfaus al clenior alin i teepsnai i Oa, 98 45,08, Frecvenj i drats conte echipa de IMD tebe feileze fone sone concerate olen nepearistares pacentul fn enol nepal ryProbleme speciale. Limit al interven Tncstarea ons la acini dazap pode i, cx sia po- pl generals ‘esis studi comprehensive spa ui frmacterapir setae pe tren Fan a pan lal Recomandrl de cerstare La pacienl cu BCR sit neesare sti penny evar farmacc- erp efector averse ale medcantentelr ulna a aet> peca man Perr idertificareaclor ma eine interven pent teenie umatllpaceni deal, sot neces studs racom ate. Pent erties efector arerper amet ss pogo = alu pacienier dalizai, ete neote de sta randomize comrc- ie CCOMPLIANTA LA TRATAMENT LA PACIENTH HEMODI ‘ALZATL De a Inceputl air 70, comping a tatament a rprezett un subiet de interes stile clitice. Des in pez est disposi © literatures vasa pe aceaas tem, In azul ttamensoreronice ‘exit ned rumerose aspect probleme legate de misuares ‘omplanel de deri compan ide strategie mei 33 ‘oimbanaaenst™, Homodlalia ese un watament comple, pesupuind err cons Gerbile din pate pte. Frcrenta Inco! cae picleniorhamodalzt depinde in mare mfsurs de modal i are {ne dein Se onset ca cl putin 5% nr paces emo Tia samt incomplang la unul Sa alu ie especie legate detrament™419920,Acese date suntin concord cv ee rapotte inca aor boli care neces ttament de rg Sura Desi Deoarece mu exlst ned un standard de au in defrize inconspl- ‘nels tlament prin Heel, comand ose tia elned a maser ncomplians care s-au dvedt 21 soite cuspltlizarea monalitea paenlr temoaaliza 1 aber de la sau mai mele olin de bemodalisona 2 scurtarea wea seu mai mur gdje de ila pe un cu eet pia 10 mine 3 hivell peal peste 60 mEq | vel Fnfosi peste 7.5 moa 5 plsul poder intedaliic de peste 5,7 9% din reuatea ideal Din acest, se consider cea bun validate oa pri dol Indiator?® (as nia compliant comporamentlt™)ceearece ‘otf confide factor fies modal C toate asa, ‘pot frei ace in une de motvul absent sv seit si yd de ai (nei sao ru) Astoria mista com oramertldacomplianeftraumen este neces tnpul el = rocentl dep near pacer face dali compra ex rata foul reser de medi Dei neste o al in adevartl en evil incomping a ‘wotuent ae aproximat aclu cucterscl le uel bl soms- * prein factor de is te evolu montrints un dspoibile munerase interven eficiente mente «8 6 vais, + feevet, compli cree morbiiate y mraliaes; soon cus varibl lun pace dat. Factorit care afectem24 compli a (ratament @ paienior hemodiaiat Un studi recen2a investiga lun numa foane mare de pie hemodaiai(aprxinatv 700) proven din te continent, pre Actor incomplanfl i ttament Rise mai mare de a incompl- 48‘fi. conta a: paietner (pent absense, per fsftene pls pondrl ntti fecle pen pl pon deal nerd: pcienleuo endif Tied bun ge eae na sven un foe de munea (pein hipertoltemie: peti ele {au singurt (genera pefosttemie, pace cu depres (petra Saran absenja de a gedit ce Gale) unto (saa Senta del epi sein de dai pe unt pls pondeal dale). Predictor cei mal pues a itcompliane! au Fst isi cuprinsa tre 20-39 ant fat. Pale eae eras incom pln unl dines parame aeau jase Seria mal made 2 fincompian ilu al aspect Iya de watamest Aroioresincompllane Ie ratameat ow spitalinre yi mpenvie- {uiren pacentilor hemoditiza Incamplina Is atsmen compre gnsapacientld an po tram de dia cronied dea atinge 0 fom fie anime poste ves pe femmen ling cosine negative seriome™ soi reenle ‘ssi asociereaincompllns la ater a pasenr henedal- 2alieu aa de spalaare gt eu morales" ‘Un model explieat al compliant tratarent DDinpcale. majorite moda depen de cooing daren- tal pcesare pen a agnosia” gina erapa incompan- (eA 0 solute global pes ezavarea probleme! inconlinet ‘exis, sd modelele componente pt serv a pune de po- ‘rein ientfieares conor cre aeea compli a arent Sn stbiiea sear mente so bans. Un ste de ‘model ee cel props de Me Chisholn2 cre ageph ame = ‘inten forma compact, Modu explie deca estar Satta punerea lon practi porting de a analiza inivideala ‘boner rscuor seat ig. Reza ses anaize tepid de factor cum sunt exprtenta personal, cuoyine despre bel lamers, precum si variable soci-demogrtic, tote scoes afeetind deci de ra sau un aaron oa Reprezntrie mentale ‘Amconidrat neces ineluderea in acest model a representilor ‘ena pe cre pcientl le are dese bela sa despre tamer@ pe cael umes2 Concept este cena mola de slorepare ‘omporumentl in snot gf boat al fl Levee st eo, ‘reer. pe lag nteun rico publiat In revista Netlog CConforsacstl made, paclenul exe 0 persand cae se comport ‘lon ar alnea incor eu teil sale impli dep ro- ‘ia Bal ij repeaz comporamentul adapt dela meet la ‘momen. Reprezenlle mentale media practe omortamertsle ‘apa, respectvnesdapttve a bol CCereetirie in domeniolpsiologit sna au evident vain i consstema a. cine) dimenan! le repecenirilr mene axcoto0 1, etaea bol - eat dimensineinlade eta (ex. am cancer”) i simptonele bal 2 cul boli ~ se refers la expectartele pean in cen ce privet dua boi 3, tnaee boi refer a ator considera livid ca ind "aspuettor de instlre belt, 4. comecinfle bli 0 refer a impact fie, emofona, soca) $F ssonomic a boli, preopet d et individ 5 conroliatea bell ~ avast dimensine se refer la eed ine indisiult in possi de vndecare a bli In conti, individu! oganizeack eoginele despre boa in jurul umatoarlr fare ™ Car este blade cre suf? (dentiats boli) Civ dur? (co boi = Cen cauza-o? (cauel boll) + Poe f vindcaé conrolbitiate boli) + Cur ma ve ate? (eonseijle boi) lorrepreensie mente le ne ol peice ons In spn sure pesonale ale indivi! In acess iets ‘Stull mpreacnariloe mentale ale bola neces contrea wor hesionre, cel mal lat find The lllesr Pecepons Quer ‘omar (PQ)? forma reviaut a acesui chester (1PO-R) ‘ste prezni Tn acest ghd (vel Aneaa 2) ind eesti “unstidicupeinaiod 62 pacer hemodilieat dn Cental de Daksa { Teaopant Renal li, Srila ert per pri dt in Ro- ‘ni noma etal refritonre a pened mente ae ps aciel eu IRCT tea prin hemodila # despre impact aces tor eprezena asia compan la ingest de chide peioada indies Resulel cect aaa 3 pcierti al pata compliant lre- mul eichide dezvol react emooal ma puerice in gS boda, consider eb IRCT are corse gave asia vii lor Decepinds 9 dilza mal pin eften fh eontotul bel Stud emonstesc i fll ed pec eae considers 8 oul lor este ‘nim in edapars obola renal crv fe mn vt, ie ‘i vechine mare in diz say nv oes fart bine afeiunes. ‘ubestiniado-i seven bol decare suf Cate aces cae ‘eri de pci tebue cat in rod speci. eategorile ele a predispuse la nerespecareainieilor medical. Intervent psttolgice pentru imbunitiiren compliant tratament a pacen{lor emodaizat Exist un unir mare de tdi cae view imbuntijirea compl- anil la watanen a pacino hemedtaliza214, special a com- pine ep de hid, aceasta ind el mal dif de abut ie mergini pe tren ing215.216. tn review recent na onsale oftervene minimal epee edvare pace tn legac reginl alent de hie. Ca intervene uid, cera $a dove ins iufcena To prodieres une moda omportamentle semnifative gi de ducta7. In pz aor fea Incomplans la vatamedt include combina de teri’ $i stale pshoogice eae sj pacientl deol eomportanent "lnttoas,climine comportamentle eric yabameliorezs le turtle emofonale, tn caraln care peejt exactons psboplo- logis evden 20 CConcezi Recomandiri CCompliana a raat pacino: hemodilizai este aacat see nifeaav eu spalzare i monaligea. Din are mot, buns, ovina ia tratanent pacierorhamodilz repre: “Und daze abectvele principale ale stv pbaigor din cutee edad + Movaliaica rin care piblogsl completearh in med det cul medialSuccesal unl interven pstoogice care vieaz cetrea compl ane latent depinde in mare maser de: Evaluarea coett comple! (pe baz stuilor care a8 denen parameu incompliene’ predictor ca mal seal feat) - Prezeata in pachetl de inrven aster cogitive-com- prtanensl, eae gay demons efeieta in cbjrea noe Fezulte consist i due, in pate, nar oat compliana component a pacer nu este nesta adeevat in protocolele getter de dina, Re- levania ei pentru prognostic pacenilor hemodaliat neces alla indelorcomplane’comporamenile prin sui men ‘ice gi evatuarea lor cure in conte de daiza cin Rama PROBLEME PSHOLOGICE ett DEPRESIA MAJOR. Depesa majoras cactraan pein tae suleeasc depeinat i perder senifctv interes ints atv are persis el pula 2 sp.mde ise aseiat eu min pr din urmowele Simpiome: tur de apt stu som: Inrleepsitomotre say sie oboseal; seamen evioviie sa nlite; probleme es once: idea sucidart220 Inucit mule dine simpronele somatce aoc eu depres sum, de asemenes, simple ale we- ‘ie, simpromele coguitve sunt ideatort superior In cea ce pre ‘ot evalures depres I pier alia ANKIETATEA Anseatea re att simpiome floc ci spsiologice.Aspectle patfolopce, cae pot Mma relevant tune nd se evlueara pace ‘nti cu probleme mace pense, cud: seciment de Hips ‘de pu; sl perio! nen; alert exhaust auto abso- Hi tare interfere siaea de recta ees probleme; ndo- Ie extemeprivioaelaunorinepielamenioare capeites «de ase descurca in fia sees gi iil de contol car pot 49inerfera cu funtonres, Ace probleme po a au fit cuz. sn iver desea mal mult ect ar de stein OsTILITATEA sttimea implica compotamente si sentiment regaive, desea veconae chive fla lerpersonale. Include craters ca ‘mda, cinsimal fips de Tcredere™ aco flog aso cu depres, ansetats ose ‘Lapel popula generale exist 0 asocere evident ane depe- sie, anita i sti gi boda cario-vasculr a nv w popu Tall generale: Nu eis cereal eave se alveseaa soci! date status pstolgi pers boa ariosesculr la ive! pop Tail dlazte. Cu ote aes, nied exist o Tals prevalent a depres amvcti, ao ostlite demonstrat ia atest popu Ini, xe rezorbil el se recomandeevluare trae aor probleme cunosue da alte stuai carat site boss crio- seul, ‘Depresa anita! siliatea sept asoci cu bola cardo-vascu- lar prin mal multe merase. De exe, ace facto pot duce ‘a ponadereni la egmul dct So alent, cce epost aera fines cadio-ssclara De asemensa, un cin eave eu care dine acs st pshologie are un sc ees de ase angaja ‘in eomportmenie csc nal cum af fara, ena ce poate even tun impact neat asopa sani cao-rasculre. In pis, ex fece fisoptlogice ale depres, anit ota Depesa soit cu distinct placer hipercorislei, rs ‘ere execolaminele plaice arin, cetera ale venticn- la, alerarea cool vaal yo reducere a varibilii reven- \cfcardiace Oraredgre acest pot aves un pact nega stra boli cardowasculre™, Pain care prezidl depreseprezinis ipersctvotesimpatondienege cnn cea src pte trib Te dezvoltarea bli ero vascular din euzaefester xe olameineor aura fej eadace #1 apm ttombodtelor™ Depesa en ect ie repunelnflamator progress ol se fale secunare 25. Ale odin Raolgicesteite a deprescare au un pot neat asypa fuel cardio-vascalae sunt hiper- ‘oapleiliatn, inflam sti lcalitSlalterle ritmor ‘Uni ante patent anxigl penn o vail rae carace, 2ea ee poate determina alee paoogis a tonsa auorom arg. Acesta se poate dtr ie reset stimuli spate, ie Sori conolulut vagal, ambole find Iga de morale?” ‘Acivittes medulosirareals si contcoinrrenal rit cescite ‘unc cin aaeaen ese preaer, cea pale coubu a boas Cardo-vascalart=3.Ansieatea pots determin si Sane coronr- cee ce poste dering rupli neroclerioe™, Pacem ear prezing oxi sont exp anu sll, cum ss sacle mentale, ez valet presiosle event erie trescule compara et et non os) ale moet fe Bologice legate de boaa cardio vascular®223) Eraaren 4 tapi pnloglce sugerate in depot, anstatea gf ostitatea pcan dalzat, EVALUAREA Exist doveti ch interven sce psolgie, pot rede semi ‘av morbiditatea smoraliaiea paleo lz influenea Da eolesteolemi, presies areal, aura veneer. Dializa adecvat fi contol anemiet sunt factor care conbuie scifca la sare de bund dispodie genera claaea vie pele calla Ace fcr combina ca ealures si de ‘Site fied si potenialle fete adverse ale mec! adminis ‘wate ucbuie fn primal rnd evalu ca fcr deterinan a dope sel ane in atte eee de ili, apresire cli vit pacino di Tan prin teste psibomeric, cee ce pesupne !ealares dere. sie. deve opera de ru. Elsa ol mule sven are sprecialnivelurle depres ans esti. Beck Depres ‘lon Imertory (RDN), care ese fever spl, ex un numer bine valida. BDI Fat Seren ete nite soap ‘ie ue cages wth eee nig honed ae ™in didi 208380)40.92 6. Con a5 SM, MO) Lo etiingomdast panel other nny an ity sosepee Ee nT EBs Ph cpt hai a gr ‘elo ofa omen cog ee ah enki hr ops 67. Detrea Pe ote! cio keh arc ‘tent mr open a aaron oo {Be bu trae 64, Ga AP Hg ene, Coe RM MEKE PM, ha AA ‘Thetis ay hm 6, Gren Toe, eg He ahr, Senn, Eee ta aes deve snd oma prn Pan oes pc eto FEO Fass, Guinot Daes Ck rb ching nd tt oe tag ino yf Mei peas a ti. Neon Fas Ctr Mg CX. Ee hig nd hii om oy of We peda nd as pes, Cate C, Garde PL, Un KL Levey AS Kea, age ot ‘ee vg cit aston erin de pets ‘i el pl tice Ardent cl a nr ed Sooisssenseve 73. Eiena ker AD, Femon 9, Kann, Simp ee tg nb rpm of a re i 71a SS, Gale MR. Sine wal y poe nih i el ‘asm fe ype arin de! Ph Hed ea 138, rast 75 Dou, Rab RA, Aa PS Ran Fr A, Mon a Exe tng nha wh pease farcry sions: pees nd al non tn ue Di 197 000- Secon an aig ue) ley pipe nel jose npn nt aninSe 17a ei I ound, ie LE Peon SX. of xe tang pee en eon 10S 17% Gama 8A, Ae A Cane th ents ene amet eden af rv ar sad epee of obiion Parad Med Tore 8“Rasa Snes Chen Lama Mt, Meo LBM, etic apn ee he 0, Wang B, Cyne N, Wes dcing a ison ait uae ates Before deer dn mal aleve Saag St TNO} T- e | Ee RW Manion DL Goon Fa LC. Bla C8 Gat, ‘Theta otf pass wih age red ee El J He Tossa ‘2 Mamince DI Eva RW, Depn MK irk li, cn ton td he hen sate ey nei ep oan Ch Toop ae155.0 12 Form Cf, Roser The ep pte of emo pat rer 4¢:2007 "8 Der AK, Shen: Qaity TE of Sass eps pens Nero ineas028 "8% Dear A Sane ay L Cnn bho inline rte {ana vcon miline pt) Poy Ned TT Kana NC. Cd OD Rabie aor a ds pte tdpaing as vais By ge sac teh Phe Mal ‘purses {9 Evo Main DL Gano Ft 6, Ba CR at ta ‘Teli eo pls ih age Sa a ‘i Rasp 5, Sinan Lamesa A, Wow LJ Bas An Seer ren mine ng Hs wre hc ‘igen drone to Jay aS} 9 LaF Rn DE Kern ary WME Es aii ‘ipmay mgr tens with ne nal to. ser haesero ‘9 Lic os Roblin Adin Cnet a bhi re {ra Son We Evin ete 98 ‘94 Levy Moga Bre On Maen of Daas Sd Ea, ‘91 Kasinder Dobe: tin Hee Coping So Hes a at Diais oh s eUnies Sue Fe Pci ed Reh Felt ft Ci frm Seid Wr el Ca 002 sr 91 Co TE abs Te Es a Pov de ot Sopa en Baym epee Et Dt ‘9 White Ate od psp: pring with ptimpo ots el Nir MM: SH 25 95, Daa Gh Maniac B,D PE Bik YO. pede (Sie iavkiduy be monaran “ 96, Derr Men DC ae PE Te Kink YP pe ‘TEs a8 47. Deves not oP Main TK, Pl LC Ga Beat Longton eminem hwy peste pba 1 hoger ay En Negenloon Caro G Rati ou 8 Ton M Nan A si Loge anf ea ra sxe basocae wr nponed gio ah of Sas Ne Di Pop 2002 FOSS iy tt eng sow ESD pl he ted Say Bs aoouaressies tno CS When ste ph Dl oi 2 101 ebro, et DL. xt feral esp ad ty tion ache wean JEu Be bangyonea aa Os eS Roe rb Gams 4 ‘Moris Gosia rinse fens on ect [ioe das yet lent empath ‘eafeno iy r BE Ari ogy fh Carag uate in predating nl eer pans te ison af Song Re NECA Sy Gow re Ba Sea ‘pry ofan os pics HC Net 20333. ‘oathes Bt ys RD, Ser Ke, Fionn M Car Wanted ‘ay oft, See pos stoninedmlnre heme ‘Son tr) Atay us eras ‘edison of ar eames a sve dye pane Te Narn pea ho Adega Dp TRENEEOSAD Say Coup. sry a nosy ‘wR Ce Pict Rol Aci nt pity Comin age ee 77.ked Suse Dement of Veer Ace VA Senne alta Nowa: Pcs Popes pthread pn pt ‘sioner yon soi en ny Cans, ra aati i {U0 Obeey EL Sar Hota Ren hin bile props und ope ae any ur aos spins i in CoO me ir uaa Pn WD. Moma inp aty of e nensnge e ‘spit Peay plo prea elk Wis Sele Sener ate 751 Pine Svar AL Cony Pps etn: Dens. meanest ‘ens hier RN Og Pat ed ion a ed tan bes aot) yD 86388 ahr Sara, Matin Lang sl tng ra de ‘Se Da amp 19827 1 atta: tee on Cr lana nn be pit erty emo an J 1984273933 suseigns A Ke Tenods AE ffs vg ha tangy AR Aten 0 Csr BM, a een haa pps scram a eat aman enol ero 91581 1tMogs GE Po 8, Sm-Canern a Ure peptic ‘cist nomads plea be! Ay ar 19327 ‘tony bs modify pate. Nephrol Dil Tapa 1,S:603699| 2s SaqeesGaunls Ryton pest Hah tte Cen fr ceil ah ain yoann ep tnt 12s Stume A Amat A Ade SG Bs Exec a per of site many pc ah ng lo Rb cy un dsp ats Rea ome Dit My ed ity Sy Vine uno Du ATA 8Aileen Rp Pe 199: HL 1 finn trhocepsy fier he athe tana PL Nese Wont NW oo. ert re ng ingens Np 648792 ‘anShlon fe Blea A, WalansBS, Fes a bent of ene ‘ng an om mane ic ny 80383509 a1 babe Poin GV, ek FL Lng ee She ering nb pets Clin Nip 1722 lana Cat Coy Pye conn eed a ‘othe steg ake tung etn etn Ae seme ond led th te pn ocd sre, Sites sng dn 7 ‘Eh De osoaceat2 ‘een iy Iasi sh Ke 3 Paflter S e Ci D, Caper, GBS i isan ese mo. prey hy men ae, Mc T Kampen Bh Le CO, Bae The in een ery ins aed te ed ‘hes mln ment re 1909998, ‘srl Gene Ramp Nama M2, le Low nis ‘ac ins phe msi a peice mob dneothpencia nh nometa esaoec np of US. Stan Gener Py ey nd Hh Rope of Segnalo a om re Pe The eof ie it Nao Conn pve. eine a an eno ah od pres Naol Har ig ld ‘tN! Chit Even Pj, Tas Ryo ote Exe Pl ‘cio tau an eset gh ls eset Aa at “amen Pan Btn M,N NLD, 08 HahipioreamsonUIpdiegat The USRDS Date Moriya ly She th Rot i So, ly 9, amie Mt Qaueaing Wa eel Abu pain ebslo pan Ky 198; 71018050 u Aba 3 Tors, dbs Di ks KN-LDL io “nrc pen agen me Cr Bch ESS. Main Gee Lan, Ex end ad inn so any of tage ain ios homo s. ‘Net erp Sas ‘Wclnedde RBaka Ls Ry Ft Aled fwd vodlatin of cca hhc uN! De a hn De en a alin nie Ficadeb ups U, Caretta ‘istcia pny incr ane wih pera std Se, 0 eDinte Ha WL Ec of ec igo plan is nd pein foe Yu Si Rs ATT stg Gomes Eig Tree tt fe my brio ps Rae DIN 9 15 .GanbILOMINT Tov cal Malfosn oem ae woh "Seove ning m so men ps Pho WAKTETED 1. ssaiiphas ¥ Seal SE Sa a) Nop oe caress agente tn pend rr rise toc ek eR ened eo haar sag A inlay Deo Naar ae in npn sr! ph ener mbm heme en Mw dul ase Opa co sya ian Eg MG ate io 1. Corey ML Nemo A Ohl Mi ne ie Tce beeen tehing tr odes Kany br Sa Tes. sng ates ain ay eR eg mee Nast A Oa tri ae rng oy ‘0. we cy mba tones Nope 3131, sLDaimint Koa Os oar Cos ae secs oon rine ane pte) Cano 035 ssn Kos oan A et ps i ek crayon on moa tr) Cr B70, 9 SiON kia] 2) sonal)1s) IM, Golde AP Es A, Hac GW, Dele A, re HR cians nin wanes KL Chea MLNG AY, align CS, Sebold, Kn Tin A Piel oi nase sty en ‘ont S7.286.29, 20 ‘angina ny of marta! sas body composi, and psi fncton ‘Seo een dn) Chr er 728,208 ‘ea Albu M,N, Mess A, ig Cuban Oy Toa Dag The ls af uc ing onc eal cytststa Wh Chan Ml Sa og oe ME Can CharT ‘ones of eri ting ations canes ambulio peines there Panos Dt Sy Gnd tr PL ear KR, Mil 1 Gem omy ob ac nm ps Usama Nee dN UM, Thay DR Sep WR, Haingon {Kt A ee of ot vg ng bem Rs inc ule cons ih te alg i hone plo [ine 36-0 0 ‘ornare Catt. Pl SM, Pie Heke Wa of re rng ar tain tomar ca ee pty Sd ewan uly tenn bu 9865308 ‘wtShaan fe amet! Ja, Wine RS. Mesum RG, Demis VW ey nd cto i ps mn MF Long Sunshine olizany tees pe ‘he po 2 mia Maal Shtan Suara Nom, Mare FE of ‘esac hanes opin nee ing on ae pty Needs tens re 1026, 158 ‘1. Al Sah TW, Tier Ce Fly spr ye na Send eh i tion ied lg trae JS as Kk, Une. Sd ani nd ath Since ipeeaesiesis onotace malin wen boc eos. Rey bt OR atretin, Capp, ie er he ae een ‘orga nl pgsctgel pecs A rr we sagas ote. ‘Bees dps rai Pea al a3 rrshicun Wa, Als Cul tal enc ut nd uy fe eis ely aly anos ptt eng eet en a dane. J Cir Ea 9 He) eben Wi, Sy, at CA Scalp a ct hang ih nats rok nS pd a won nl mia J uy ms DS nnn soc gan tJ Ky De MRE ‘a Kinet, alan eo KL a Pale ing tof ied col ene pets iS i 96 P13 ar Saar ag 1 ayer ab Nea Sen soot it ry, npn dpe poe he DOP wakin! Pasar, is KL etl yatta el de dl mor tan mis pnp 20 HS any WO a fis seco ft tn ely tiyadagely ae unre) Coal Ce Preto 994 643203 tastes eer Dom Ste Fay ta a meen an Sc sa ess av kan moray emote pa ue lato BX emg CA Coie A. Sening adeno ents api bethany be 2Coton nck notype Seo any fsa ais 1yoihenbern WE ot Mg EA Bs eh AB Gee ie ipa waar, Yn Fe EA un ed inex ss yeti ef ty Neda pd diy De valle, Pn Caso A Nai, Sa ME, Lis OC ‘ithe wpe nrc ce meaty end oedema AE cnet {keto pce yar say eos a Ch Tins ar seg osha aT Foe, Bee Fao A ove aoe LSet A, CREED tress tpn [spec cova echvs nba, ay a omens vse Me FTG ZaalC Pom ae Se Sint mre: ors srt ins ab on: a yng wo? Gana Ory Sse Cpls nl an ESRD wren Bt Mas Ch, Danco, Nezmon AR. Test oma a ng ia Sueno apr! 6930 zotbane es Sa Nn bod pe copie sig ono usc Sm: Sed) ISTO 2 Sie Be Stow 1 Tr maga of comple nnn. cs RB ey Dv, Sot Db Contac eth GB tort Hosen yom 6 aE suai 6 Py Onting ms mc te 2esld yar Fe Ne RA, The oe Roma ptt or hyo oe S036 200. ty. inane end ent on erly n pte i e-go once,epon DPD 2s nin MA urn onopanps ian i e Gin ow 2 1 6an tnd payoeg eh a A, Sng N Tefen a msec ie nba Tm Cove MR lpi ene ne data Ul ler 0 ures ctr dle ee sac vat pogane de mblr Aefolpe 20 PELE 2am Cont 0, anmarin Reve ins enti econ nag ub wi smpame Hela Pealapy DRLOS orig oh Ly meg se rs of ap ton ce mn A Fr ener aor ofommon ce a osc 19507 auNoerD, nest Commasoornde fir became hp en at Peg 8 115138 as Brakin RBH RD Me at J Te Bi hs Poeon ccs, f Poche Noa 306 6-07 si tet sancti ati ean ‘Nein a8 2143p Gun AL Agen ew of peel ee ‘ee he am of smc wae oes Poe ‘vate fry oe Hs 2 Ean sone das SoS ed OSTEO) ‘sot mace nga 8 198 8.30 219M CA Grr copa of CT coi ee ron Wie ‘CX Cope Bewoa Thanpy fr Croc Meal Poneto ‘Sct ed ements New Ys Wy p30 itlatioget dre efor nb Be bo 1p) ie MR, Can A Deg C- cpine Shin pp ped wae srs ewe oe ‘Sete at ann Br 20 & oto) saa onc apn ty pdt oo Ieing ear dor an plans rtm Crete 22 fe Chg : rie Disonn,Oxd ety Pes, 179 eigen aot sb Cons anne Shon Nin Spi A. Mid KD: i of epi to so fot a cry at Bas he Nemane Sng SH]con 9: 50-3906, 2005, 224 Manan DU: Evie DU, Nano CBT ony epetion = ‘etme ie enya eter Gen Prior or a0 226oy KE. Wile DOr CM: Dees nova hese: ‘Sean fit Pc SE 26, 20 aa, thet 4 Rip: ps of cng ce he sere ocean rey, rir ncaa on entation acm 1092, 1986 29S BC uy MM, Neue etn corer Beat: A sn or ea E03, 2 2am A. Bama, Kalan le of yh fen he vse deed aps br Craor 231. MRR: Pg in it. Senne dna cn Pat Gooey ah) oc Sia Pacman Be 2a Bl 4, Kp tapes of php fi no ete sne an y e 2S BC ng HM: give tin nd cory Ar incre 245 Bi ge maton nowy dene A ow 2DsKima Fe, Ho, A Soe i emo pin: ete tan oe gr 13, neti A id in uh RWG “iyo he Be Depo vena Sonn amps on 27a Whe, he i Sil naples: Be tin tn a ep 127,18 2aabedea Faas pert non th te pain ind ne on mS snes eet ‘oo oe anes on 2ont Kae 1 Maes DL Ca, nin Cte WO, Ka (tp kny dean Gey sie Sn OSL rk 1h Maal rn Sgt Me aN, he aphids bps2 Amd bloga fhe WHO ay of ile cme ret "WioQOL. Caer Sind Dra Me lee WH, 158 ‘ot progressive ednatlan in cone hemodalys pas, J Shoe is 38: 22g Ant TK: Rech ew nage ia eating. J Cn Pockt 35050 1 1a Mahow KA. Hines 80 Tp vipa ancora et ik Upstream! 133 36, 2athidacn Me. Nm fe Pycoigct os acing fae! enon ‘Covel di serve Pat Cnr wea Scroan Petco Obata, 12 Rema A lomena Ral fp of leg ct on he ages of qos ane od pins oy Cin 246 Sun RA: The ert wosanger ad wy Hcanous © your hai et 826 0 ‘ral 53530, 199 ux tma Bascal A, Kaplan pat of gl co he tinge eer ed prs ty Cri 249 Rion RD hans CS san DE, Sot LK Ca Te tat opens oe noted ale J Phe Dis 38 Sore ‘pl 862736 01 asi hay 1, Ambre Reach ee a ange peony, J Ct Poca $3530 1 anil et Rods Sc Cheri pate Mloecle dace spss, sig indie an Gen yc 2th PU: epson na ory ie neal pes rn Os 5 82 2pm let: Co rel slr pcan ef nde die ‘sr nts (Gem). Php, Pca hance Pred 15 136 24h PL, Racoon RA. Vl KL a Mali een of ose ‘wp sy gue my af cate ho ae257K Py snd ng ld see 2a Rie Fl aby ong a 2sv Fin sca Spin a iS tet canto Dl oa DTI 2uaheu 3 Rta Sng ho ay: ce sy fie So epeting¥Egd SC4a8 261 USS 9 a ore Sl aac th Ni Inne Dus ma geet ny Dias 98 2erlape A Boge Yoel Depa wef ety ot ining spa ie nS asa focc tka tC, al open ern fs yt i ee 26th Wed Poon RA, Sani ae 2st Kn ncn Coe The so Sse nom arn n/n B08 2s. A, Wie, Si, a i fn ag emclaha pi ieiet pel ay apr. Pp: erie Mes: ying a tic ion San Pecos aux Key 5 man is Pst er of a ae: emis Pinpa! 3030, 7 219 Melt Colhout Ania pcr smn 010 me Pena ner on ects mrt ona yr Senco ie anes malt apn igs fag it neo cor os pts oy een 21a ft Nar. A, We KD: fi ee eens os pony aera et Sas Ce Nahe Ap Soy ft ann Sin Hy NN Nee tna cay ea ene Ak hr ay ta So ane bes Lach nig Cog nef penn nto per ef ei oes wd ale cee a7on ser mec itn JCal Cn 2:80.40, 263 dna Ling SI eso RI The ve Mae Set Stay 3a fol: ope iene panes opts ‘pe rn pt Parana 8227-25, 180 str Re Ml tn, Coda smc gt 8 SSE ‘aes Bales Cal New 628258, 197 _6Kne HG Fir PU Kor Ml Reig pes a asi ele us pus) oon Re 293190 271th) Wh Spas of ay reson tis desing re amodis/Pchr Rar 63H 4, 1982 anafwant St Be Bal Aah Matogawe ppp an pao ara name andy cen ha a ‘her Pacha 253 108 | Wie ¥, Ge Beh eye net of ensercal ae: cowie dapat rr 20 Ys MOET of ap fn a fe a ‘mf at of i hn em pi! Da apa Hanne) 2 Seer Si og 1, Sted Rapa eae Xa of en oe me i tin pn lr 1928-8, 0. 2a pan Ca Qui a epoca of ‘eons Ed Ot sts Rin Ree Pa 2 vere uy fee ey nea. Np a "pon 08 125.8 ‘etalon AR Ware Grn , Raton EC, Hr abla ME The aed scones Sah An piano ds or notte os ‘mt ee su 2052033 98 2s ug A, Sadr I, Meer Kato 8 Prue GR Ra 8, ys 1D, Ps DL: Asin ah md gut fe ous nly: A ‘pom nase Mae wrk. Kaay D8, 97 ‘ac N DDK! Gm KIDOO Cle Pie Cote br Che ‘Kidney Dose: Even Closes Saito, Pet ‘en of le of i nia cmp in ll Gaels 12 ‘aon eo gins ef netoning a en. 27D Weel poe cn Noth Ss pees ‘sind st alo se alsa coma le J ig ay Sean 1997 2tslnn l ietiingat ar sty np da amin NOEs DD Deer: Ria gl di a hone J Bed Rb 97.0, 1Gh es 483 Dro ee 291. O, Maes, Mathew. Tan CC, Cubrge A, Fisiman EA: Dismal r= Cae et sie tn pe ey ta eee area raaeacaenar wot bn ie gti Sr a 1 re Dip ten te. Se aera sara SPR eee conn ec a oa ea rae nomen Sack Seu eer mation omnes eon Se inate cnn nS Ca pr oe in ee are re teas anne Gente een necer atercn rt ce tote ere seipts cet pce Se ine Cina gay siete seen ewes em cere eae nests eae ear ramen ee ‘ein in unripe with entstage real diene Ress pis Eoaratarener tint ater igre eat chonmrae a eens cop Heaney adwaws saegrgere ntti age mare seated ere te setasnoeme gi ee an to Shomrhcaaai oe8 Kemar J Jesu MA, Mss MP, ear FW Boon EV. Kae I Quit in pois ngs nnd noe aut eae ‘dy rp he NECOSAD Say Gra Port i I 240.200 wets NR enon RA, Kine = Qo Heal le oni oe wi che lotions ir ae Bu ‘Sem ‘wm ag, re Che Naty fe a pri we pat, ‘Qed 84 186 gare sows YY Kt, nA Nag Ana Hanan 5 Mama 0, Kamion S Ameren fice aly rit mal epider aan wing SF ven tindog se nto 0 ‘ce yreton a ia Ne il Pan 23 208 ‘inns CR Mono RA, Kit Pl espn a nd eri a oe iat tJ by Do 10%, 190 ‘1 ty Bs Em Dag Mor doy neon nto de bea Susie tate reps poste Cn Fompo 1930.91 area cm ing KR Ct el Dtin Rend Dias Sn tm Run Di B19) 13 Rnb Gamee 2, Wg Rapa RM Crs td ge ‘pa yee nos oa de ats Te Mato ite and in Sy J iy Dir 9 00-096, 197 314 Kore Josot Ma, hte Me eer Bohn E, Kral Quoi hin iiss ane as be on ays gy He NECOSAD Sandy Gens Prt Di 5.200 1s NR coo RA Rime PL: Qo oad ha sion 16K re HCN: Quy a ie ie pn ‘Om ik hrs sie ie aurea a at Nog ne ‘Fier mal vmg snd demas par ing C238 hal Soo Sean 3,00 ‘inept cee el ds Nephi! Dia Tha 2:2083- >in hann Ket Ri le aTouran $1920, sa1 Chae NTs GT DW nes CC in Shins A, ‘22a MV Gasman J ing Sal RM Cosson Bitte ond Sah my Dg DDAMED, OT 523Koroae 1, Jansen MA, Mote MP, Deer FW, Basten EW. Kr Quay ote mpegs oo dae ns io ‘ast egy The ECOSAD Sy Cer Lit 201200 224 Shir Ny Rone RA. Rinne PL Ql a od prc ne esi pon ih chan nea tn] Kay 3259 ‘18 25g 8 lowe MCN: Quy of He presi ee pans a if 109-16 198 snefejama atwa Yip un S Hgb Nga Arne Sana hasan 0, Randi SA hin ‘tlie i lawl mais pt wh te S36 eal ‘nog 3620.20 0 221 ep ner heen Semen Mes Mara DU eke DL Gin pero cs ode ent Ou Moinon s4Stes CR Peron RA, Kime PL: Pec of ad dope Sei el Soe ay Di 153098, 1950 529i Ds Evan RV, Depa MK: Het ly etn isons, ‘od te bel sto iy tan pws poste Toure 185-0. 18 >on ON, Tm Tbr DM, Bs CLD Shins A tae anc C cd 20 ‘ThaiSo us rte to ‘rc fe pear eng el anc swan ya gy. he NECOSAD Say Can Prt an 875,200 sn iler Recon RA, Kim! PL any oe al occa ie paca wo atin. ay Oe SST {lng 8, nel Che N: Quy oe i pei emi pt Gua ferstomi 156 eorappin es te thn en shezet ee tenoe mci! therm ar aE Ee neyo See erences Ss es me eee ERE, warns ares oe nubs poe on eR ES em moi tee a Stamens ie oe! pee St ar iceneemen ene ees emma ee Se rere Sr A eb te re in ‘and th hah ef Sly mentaon rei psp in ries testinal ee eee peered ames ce een selepencpente tet eee ree 1a ce rg nee or a ESTEE are iretiy ofl (QOL samen Qa Ue eH; SSE si toeaN ose, Van ere pe pe te pa ‘afr Moda se fer selon S36 Nee sage KA We A, Fak NE, Jens MN, Mayer KB Bes ED, Powe NR foal ans rvewof au erm a ed age ‘saa Du 3652732080 oe i Slr a Winn eer OR Kae « ‘puters ls aie wonky Doses 98IV. Asistentapsinologicé a pacienilor din centre de dializd, Standarde de practicIncladere pacienul in propa de hemodiai crocs Inijorea dizi ernie reprezntd un moment exrem de stresant evr pcintl uv insuiclena renal cones eral, Probab ext ‘a dif pect pe ere bolnael ifs cess irbul 8! n= {eleop stl accep exe diana vind boa eel. Prin i- ‘iat paenl este menfut i vig Tas functile Seu nu pot Fi sabsitute in tate Congitizaren acest fg dezorganizett ‘aa bonavul cesta nd obliga sj perceapa wel coral 50- ‘SH recorsidere roll sale personae, peoislonle fail {ntervlpholgi l inkireadializl cronice ‘Se recomardevalaespacienor In deus a or de a stbi- ie neces inert rape de sbsiule a fri reaae ~he- ‘modilia san dali pertoneals- evident dp exunieare sees- ‘ei deca pacientu) sau Ta deers de o spin in exal pie. flora care institut dain cones de urges (confor insta ‘lr clit ai server phone, labora de National Key Foundation, Seopalntervaful este dea ideac pace eu ctor de ise psi- oscil, care neces sister phologies mea, dar side ssi efologal i ania eazurlr ee umes st fe clus In program de dai cronit. El vebuie de acca reat cut! pact Engi ete ured sf nln progam de hed cronies, ‘eu excep Bienes a cel cuo Stun medical la i Se va em incurs eri lp evahuaeaamtoarcor le ‘mene care a doved fo eraia de spcialate chr pues fe 1a desfguresea in condi bun a ialz’ conic scompliana pa ‘ntl trent fii cogav oientrea, ten, memors iliges) + sans emoyional (anette, depres) * pled personae aneioare trial bol rena complina la atamen in weet = reprezeniile menial legate de evolu infietel rene = lvl de accept bolt Concsile evaa vor fredctate pe un bletin fp vor faagte foiide obsevate medialintra pailogie ees Gael wok nbs de ghitare in uremele 40 mi fd cans al bie sia saint ast voy st pnd eerste 8d epic nel vane sues noms Spun og aii com vs 2 Che ene enia a alee sxe ae" 3. Vie emai dent eo Boalt de isu acu of al pete Dead rps se a sce a rare we 6 Despina digitonin compl ria frase! 4. Coram a woman aration peau boa de ini (rolls demnesc medicament cop pena prasris)? 5. Reet wed se tame det mai saat? Des 6. Ceveaspas mee ese atamontl pce bal i wma 7. Dre se ae me? Cac ee advent cv puts vind haan ou eae on este sigur nh per? s, Ce yay espe bemotiait aes perc? 5: In genera to pram ncinat ecpe ste mesic Tinned mea? Vip ceva tna dese core na fc pln cer mee? 10.Oamea on ret Siecle ma ete end af eet de IRC ‘vst la lien pratt est ie Gatun Pan el hc psita) Da em vn steed | ‘Mies cee! ve?” ‘Dac pac eh snpowe de depres natn, conti cy 1,Gerle near a a nh pln se? (fea dpe venir i oy, es In fmi omg) 1a Saree eta pol ces oc (exp pcene ‘ese eer pa ascent pe dfn cn patel ain. 13. Conia eet pees prenatal pogrom sia eo sca care vai? ee[samen focior cognitive = incezia spam snen? Came rt ced ef ee cum (08 vt nen? ares repeat Sop mine age to. copa, Dore le I nal el, dv ve lea, je cdma Spole oda |. Viet spne ce mime id mops ere re oes 7306 8 4 Va amici care fost ele 3 eave pe care a mga set? rio 6 2k = Vag sb pu opt cavin 1 inh etd idee ‘ate st spe deems ine: poroclSings mica seals |= Cre seit fr de elie ye ce: man mae same capes (Gree asonimtes Se / ses? usando > Cee al mae eine sor ome? ‘St dl aia nmin pe aes ep ar {insane yore jour east ‘trv pllen ws npr Examen! fnctilorcouitive Examen finetilorcopitve fn cunul irs poste linea evar Fe bza sparse pe ae le pit Iss ot pt pat cane frm, pe evar ere a memorel de sun dora ined ‘mul (pin 20m), nun eb de evar cap a de ifelegere abst» seen, cose, co ‘iw ope bi de elu (stn nurs extrem de ‘paca in xl pacino cre nn rogram de iid petorealreatele uni asl de examen vo consi un 7reper pentru stbiliea uel strate de ducare ptr car penn parte plies unu test rcuropshoogi- de exrmpl, MMSE (ni ‘ome! Stave Eseminton) (Anes 8) ‘twat clinic va ce care vadetemina sborara cea mai otv- {Se ecomandA ins o eur evaluae formal a funilr epaive ‘nto pci cu vite peste 65 ani. Prezeatm in cotinareun o> sibitmode! de evalu a urlior cognitive Evauae piosocl a pacer hemodliz Datel obnut pe baz ntervii plop aire hemo ‘zai vorf complete ptr evauarepshosocil fe maxim 30 de 2le de a extermarea pacenuui in spit confor indeatorllreli- ‘ici al service psbosoile, labora de Numa! Kidney Fawr ‘darion). Scope aces eva ese sels de 3 ene pene i= ‘are paciat in pane preblemel aspect pov In pan Tai, comport emoina conic soca: solo va ec= {e mpieaile acestom gent tataoen, fumiind echipl mecicale informa necesare peta asigrarea eee mai Bune ings Re- values pshosocll elt va consi bua attr de eae bilare sabe de comm scod eu pace sel ential paolo, fia de evr psiosoil pe are © propancm (Amex 6) pote fi folsit$ u pein alain po- fg de dala pertoned. In claborareac 3 pit pear o ca Fear numeric a lnfermajilo bjnute de apie el pen a scesteas pat flste x ufuri Insti medical i psto- logos reaizate in cen de ali. Montane piso paler hemodiz Dat in fap hemostizn steun trataent de og rato re presope peezni pacer nce de hemodai de 3 oi ‘espiming prog a n od evident nevoe de un insrumest 4 ue in eae sa peta consemra modi apart In sta ps hasocils a poiener,rezlatleevaluoepofaogie poi: {intervene psiolegic specie aclor rear cu reat {nel objnute Dincolodeacete obec, fade monitrzare skosc creo propio (Ants 7) poate eve pslologl ig pat organiza activiatea nce de hemos 21 (ex progmares paleo) Pathog poste poi orcind activin ffl enh de abit, dach cesta o cere (in czal ambursi servicio psi- hogs, pe za aes fede lc sept face ror) scsvtatenpalologlor din cenele dedi recvenaconsl- tule, til intervenor este, eficienaacestora et) pote investiga; pot fast dentiewe dificuaile cu cae se enfant psiolgi, pot uate mas de buna a sar tilorpatologice ee informatie eistate ptf folosite in suai aso factor psthesocial implica fa prognosiclpaicglorhemodialza Figademonitoricre etosoils eble devi st existe ndosarl = al pace slo de fg de eval peinoroil Dad in cz In ere se fureaz individual eu Recarepcient in pare, mogul de Invegiare tn acest Ta este event, Yom dese corinare ‘modal de aera eu acest fin ez in eae psiologul inna Intervent de ebiltare care vizeaza un grup de pie Spe exe pl dart ilerema de relter ae a obec conintarea Trasplanul renal ca opiune de trauma, la rubies Problems enfeath/ Acta pactentull 3 aaa in fi Bechet pcint Vizatobiectval ira Larubrica values vor wece dle ‘are sti inlerea tern de ebiliane respecive (ex. .7 din 12 pack hemodialc na cunose avn dezvangee rans isn ea) Deosebit de important tina bit: Reza nerve Tn cara rene nals, ada eval efector interven de resblitare (ex. fa und) sv nota ina ei pociet nels una din uaa variant: pacientl nu ese ies, pacientl ay ‘exclde transplan eal ea opjiue de tatament in vite -paciet pels de asepare sau tn cae de donno via trudiAeste ‘xempifies au desig ol cena beraten plop nes eps modul de inepsrar a date ete epi.ibograe 1 mile ee a emia eo 2, Fetch Chace Tem Te pet fr wig protege ‘ee Gao Pres New ah 8 21 Monto ctancsqaiy igen teas wk pe ‘Se Depp Cana Reso Sod Wats, No ey 4. NAEMIE cle ind: esl wat md pend vie ‘ert stings rey + Toggle par pp 8 Eamtaee 16 Seas rachis rain Te of uke 4 acd pe ‘fe nhs, poco os fc wanes ms ed oer ‘sl at pra deen Ws Sis Cpa. ed, Mor OL Ger. Mine 2 Te Sc Invcn fr Ret! Trompe. chon, 413, 300, 100