[内源性再输注血液透析滤过（HFR）的急性生物相容性]
[Acute biocompatibility of hemodiafiltration with endogenous reinfusion (HFR)].
作者信息
Aucella F, Gesuete A, Sereni L, Netti S, Savastano A M, Querques M, Specchio A, De Min A, Avanzi C, Montemurno C, Grandone E, Cappucci F, Procaccini D A, Stallone C, Gesualdo L
机构信息
U.O. di Nefrologia e Dialisi, Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Foggia.
出版信息
G Ital Nefrol. 2004 Nov-Dec;21 Suppl 30:S185-9.
PURPOSE
In order to reduce the hemodialysis (HD)-induced pro-inflammatory activity we need to use a biocompatible dialysis membrane, avoid backfiltration and possibly use adsorbents. Hemodiafiltration reinfusion (HFR) is a new on-line hemodiafiltration (HDF) technique combining these aspects. This study aimed to evaluate the biocompatibility of the single dialysis session comparing standard HD and HFR.
METHODS
Eighteen patients on chronic HD were enrolled in five Centers. Patients underwent one standard and two HFR study sessions; in each session we evaluated leukocyte activation at 0, 5, 15, 60 and 240 min; and interleukin-6 (IL-6), C-reactive protein (CRP) and IL-1 receptor antagonist (IL-1Ra) levels at 0, 60 and 240 min.
RESULTS
Leukocyte activation was similar in HD and HFR, while the post-dialysis IL-6 increase was lower with HFR; CRP levels were stable during HFR, but increased after HD, and IL-1Ra did not demonstrate any difference.
CONCLUSIONS
These preliminary data show that HFR still has a better biocompatibility in the single dialysis session.
目的
为了降低血液透析（HD）诱导的促炎活性，我们需要使用生物相容性透析膜，避免反滤，并可能使用吸附剂。血液透析滤过再输注（HFR）是一种结合了这些方面的新型在线血液透析滤过（HDF）技术。本研究旨在比较标准HD和HFR，评估单次透析治疗的生物相容性。
方法
18例慢性HD患者在5个中心入组。患者接受一次标准治疗和两次HFR研究治疗；在每次治疗中，我们在0、5、15、60和240分钟评估白细胞活化情况；并在0、60和240分钟评估白细胞介素-6（IL-6）、C反应蛋白（CRP）和IL-1受体拮抗剂（IL-1Ra）水平。
结果
HD和HFR中的白细胞活化情况相似，而HFR治疗后IL-6的升高较低；HFR期间CRP水平稳定，但HD后升高，且IL-1Ra未显示任何差异。
结论
这些初步数据表明，在单次透析治疗中，HFR仍具有更好的生物相容性。
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