Evidence of benefits and achievement of high-volume hemodiafiltration
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血液透析滤过(hemodiafiltration,HDF)结合了弥散与对流的溶质清除方式,以更好地清除较大分子量的尿毒症毒素.该治疗模式是否可以为需要肾脏替代治疗的终末期肾病(end-stage renal disease,ESRD)患者带来长期生存获益一直存有争议,近期高剂量HDF与高通量血液透析的比较(com-parison of high-dose hemodiafiltration with high-flux hemodialysis,CONVINCE)研究结果的发表或将成为该争议终结的里程碑.本综述系统梳理了HDF临床获益的证据以及高容量HDF实现的重要影响因素和阶梯式实现方案.
Hemodiafiltration(HDF)works by combining diffusive and convective solute removal to pro-vide a greater removal of larger molecular weight uremic toxins.The recent publication of the CONVINCE study might be a milestone in ending the controversy over whether this treatment modality can provide long-term survival benefits for patients with end-stage renal disease(ESRD)requiring renal replacement therapy.This review gives a brief overview of the current evidence for the clinical benefits of HDF as well as the im-portant factors and stepwise protocols for high-volume HDF achievements.
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