透析模式对血液透析患者预后影响的思考  

Effect of dialysis mode on the prognosis of hemodialysis patients

作　　者：王楠[1] 林洪丽[1] WANG Nan;LIN Hong-li(Department of Nephrology of the First Affiliated Hospital of Dalian,Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院肾内科,大连医科大学肾脏病研究所辽宁省肾脏病转化医学中心,辽宁大连116011

出　　处：《中国实用内科杂志》2021年第11期926-930,共5页Chinese Journal of Practical Internal Medicine

基　　金：“十二五”国家科技支撑计划(2011BAI10B08);国家公益性行业科研专项(201502023)。

摘　　要：血液透析是目前我国最常用的肾脏替代治疗方式。但是由于中分子及蛋白结合毒素清除不充分,诱发或加重了各种透析相关并发症,并显著影响尿毒症患者生存质量及预后。文章从尿毒症毒素清除效力角度,针对心血管疾病、肾性贫血、慢性肾脏病-矿物质和骨异常、认知功能障碍、淀粉样变性等并发症以及残余肾功能的保护,分析和比较高通量血液透析、血液透析滤过、血液灌流等透析方式对血液透析患者预后的影响。Hemodialysis is the most commonly used renal replacement therapy in China. However,the inadequate clearance of middle molecule and protein binding toxins induces or aggravates a variety of dialysis-related chronic complications,and significantly affects the quality of life and the prognosis of uremic patients. From the point of view of the efficacy of uremic toxin clearance,this review focuses on cardiovascular disease(CVD),renal anemia,chronic kidney disease-mineral and bone abnormalities(CKD-MBD),cognitive impairment(CI),amyloidosis and the protection of residual renal function(RRF). The effects of high flux hemodialysis(HD),hemodiafiltration(HDF)and hemoperfusion(HP)on the prognosis of HD patients were analyzed and compared.

关 键 词：血液透析 血液透析滤过 血液灌流 死亡率 心血管疾病 

分 类 号：R459.5[医药卫生—治疗学]