个性化血液透析:使用更少的水量,是否可以实现类似的血液透析充分性?
Ali Aktaş1, Hakan Özer2, İsmail Baloğlu3
1Department of Internal Medicine, Faculty of Meram Medicine, Necmettin Erbakan University, Konya, Turkiye.
Turkish journal of medical sciences
|May 30, 2024
概括
在血液透析 (HD) 中将透析液流速降低到300毫升/分钟对许多患者来说是有效的,节省了大量的水. 这种方法确保了女性,体重较低的个体以及使用小膜的人的透析足够性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 水资源管理 水资源管理
背景情况:
- 土耳其的血液透析 (HD) 影响超过6万名患者,患病率不断增加.
- 透析液流量 (Qd) 对于HD充分性至关重要,标准疗程消耗约150升水.
- 节水是医疗保健机构日益关注的问题.
研究的目的:
- 为了评估减少透析液流量 (Qd) 在血液透析中的有效性.
- 为了确定是否可以在不影响透析充分性的情况下实现节水.
- 确定可能受益于或受到较低Qd.不利影响的患者子组.
主要方法:
- 这是一项前性研究,涉及两个中心的81名血液透析患者.
- 每位患者接受了3次标准Qd500mL/分钟的3次会议,以及3次减少Qd300mL/分钟的3次会议.
- 用在线Kt/V测量在每次治疗结束时评估透析的有效性.
主要成果:
- 在线整体Kt/V值在标准 (500毫升/分钟) 和低 (300毫升/分钟) Qd (1.51对1.49),p=0.069) 之间是相似的.
- 男人显示低Qd的Kt/V降低 (p=0.019),而女性没有 (p=0.069).
- 在小膜使用者 (p=0.931) 中,低Qd维持了Kt/V,但在大膜使用者 (p=0.006) 和≥65公斤的患者中降低了它.
结论:
- 减少透析液流量 (300毫升/分钟) 是特定血液透析患者群体的可行选择,包括女性,体重较低的患者和使用小膜的患者.
- 个性化降低Qd可以带来大量的节水 (48 L/session,每名患者约7500 L/年).
- 可能需要进一步的研究来优化所有患者的人口统计数据的Qd,特别是那些体重较大或使用较大的膜的人.
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