Maduell F
Servicio de Nefrología, Hospital General de Castellón.
Nefrologia. 2005;25 Suppl 2:15-8.
An accumulation of uremic toxins occurs in renal failure, interfering with different biological functions. Low-flux hemodialysis only clears solutes with a molecular weight lower than 5000 Da. High-flux hemodialysis improves this clearance, being limited from 15,000 Da up. Hemodiafiltration techniques, mid-dilutional, post-dilutional or both, with high reinfusion volumes, are the most efficacious cleaning either large, middle or small uremic toxins. Protein-bound small-size mole cules are not properly removed by any technique. Research in technology and new therapeutic schemes are still needed in order to achieve more physiological depuration methods with better future results.
肾衰竭时会出现尿毒症毒素蓄积，干扰不同的生物学功能。低通量血液透析仅能清除分子量低于5000道尔顿的溶质。高通量血液透析可改善这种清除能力，其清除范围上限为15,000道尔顿。血液滤过技术，包括前稀释、后稀释或两者结合，且再灌注量高，是清除大、中、小尿毒症毒素最有效的方法。蛋白质结合的小分子无法通过任何技术被充分清除。为了实现更符合生理的净化方法并取得更好的未来效果，仍需要进行技术和新治疗方案的研究。
