血液吸收与血液透析结合 (HAHD):国际专家小组的一项共识声明
Thiago Reis1,2,3, Vincenzo Cantaluppi4, Marlies Ostermann5
1Division of Nephrology, University of São Paulo Medical School, São Paulo, Brazil.
概括
新的血液吸收与血液透析 (HAHD) 显示,通过清除标准透析不充分消除的毒素,有望改善患者的治疗结果. 需要进一步的研究和标准化的协议,以获得广泛的临床采用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 身体以外的治疗方法
- 临床研究 临床研究
背景情况:
- 维持透析患者由于各种毒素的清除不足而出现持续的尿素症状和并发症.
- 目前的透析技术无法充分去除与蛋白质结合的和中大分子量尿素毒素.
- 残留尿素中毒导致显著的发病率,包括心血管疾病,炎症和神经系统缺陷.
研究的目的:
- 批判性地评估当前关于血液透析 (HAHD) 的血液吸收的知识.
- 为一致的临床试验设计和数据收集提出一个标准化的HAHD协议.
- 为了促进对HAHD的广泛采用产生强有力的证据.
主要方法:
- 对现有文献和对HAHD的临床经验的审查.
- 关于程序标准化的讨论和达成共识.
- 关于结构化的证据生成途径的建议,从观察性研究到随机试验.
主要成果:
- 在处理未充分清除的尿素毒素方面,HAHD表现出有希望的结果.
- 当前HAHD程序的显著变化限制了证据综合和可比性.
- 需要实施科学和医疗保健政策支持HAHD的采用.
结论:
- 标准化HAHD协议对于产生可靠的临床证据至关重要.
- 为了支持HAHD的实施,需要对证据生成采取分阶段的方法.
- 客观评估和标准化应用是改善透析患者治疗结果的关键.
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