Emperor’s syndrome in the COVID-19 era:Time for patient-centered nephrology?

• 作者: Athanasios Diamandopoulos Dimitra Bacharaki
• 来源期刊: 世界肾病学杂志:英文版
• 学科: 医学
• 关键词: Emperor’s syndrome Chronic kidney disease Guidelines-based medicine Patient-centered care COVID-19 Evidence-based medicine
• 年，卷（期）: 2021,（1）
• 页码范围: 1-7
• 页数: 7页
• 分类号: R69

摘要

The coronavirus disease-19(COVID-19)pandemic has been a wake-up call in which has forced us to react worldwide.Health policies and practices have attracted particular attention in terms of human and financial cost.Before COVID-19,chronic kidney disease was already considered a risk multiplier in patients with diabetes and hypertension,the two now being the major risk factors for COVID-19 infection and adverse outcome.In contrast to the urgent need for action,the nephrology field is considered to be in a state of stagnation regarding the management of chronic kidney disease patients who still experience unacceptably high morbidity and mortality.Ironically and paradoxically in a field lacking robust clinical trials,clinical practice is driven by guidelines-based medicine on weak evidence.The Emperor’s syndrome,referring to Hans Christian Andersen’s fairy tale,has been described in medicine as voluntary blindness to an obvious truth,being a weak evidence-based therapeutic intervention or weak health care.A promising positive example of improving heart and kidney outcomes is the emerging treatment with sodium-glucose cotransporter 2 inhibitors.COVID-19 could boost actions for patient-centered care as a positive shift in nephrology care.