Muñoz Rosa, Gallardo Isabel, Valladares Evandro, Saracho Ramón, Martínez Isabel, Ocharan Julen, Montenegro Jesús
Nephrology Department, Hospital de Galdakao, Galdakao-Vizcaya, Spain.
Hemodial Int. 2006 Jan;10 Suppl 1:S28-32. doi: 10.1111/j.1542-4758.2006.01187.x.
Online hemodiafiltration (online HDF) is a new hemodialysis technique combining convection and diffusion and thus also enabling the purification of large molecules. As yet, only a small number of clinical experiences have been published about the effectiveness and safety of online HDF. We present a prospective and observational study conducted on 31 patients treated with online HDF in our center in the last 4 years. The purpose of the study is to compare the evolution of the following aspects before and after starting online HDF: dose of dialysis, purification of medium-sized/large molecules, inflammation, nutrition, Ca-P metabolism, anemia, and intradialytic complications. Online HDF increased Kt/V to 31.0% (p > 0.001) and reduced postdialysis beta(2)-M to 66.4% (p > 0.001). The rest of the parameters analyzed did not vary significantly. During online HDF, episodes of symptomatic hypotension fell by 45% in relation to conventional hemodialysis, and no relevant complication occurred. Online HDF is very useful in patients in whom we need to increase replacement therapy, such as patients with a large body surface, those in whom we suspect a residual syndrome or those who have been receiving dialysis for a long time and for whom we wish to prevent amyloidosis. Online HDF is safe and better tolerated than conventional hemodialysis.
在线血液透析滤过（online HDF）是一种将对流和扩散相结合的新型血液透析技术，因此也能够清除大分子物质。到目前为止，关于在线HDF有效性和安全性的临床经验报道较少。我们对本中心在过去4年中接受在线HDF治疗的31例患者进行了一项前瞻性观察研究。本研究的目的是比较开始在线HDF前后以下方面的变化：透析剂量、中/大分子物质清除、炎症、营养、钙磷代谢、贫血及透析中并发症。在线HDF使Kt/V增加了31.0%（p>0.001），透析后β2微球蛋白降低了66.4%（p>0.001）。其他分析参数无显著变化。在在线HDF期间，与传统血液透析相比，症状性低血压发作减少了45%，且未发生相关并发症。在线HDF对需要增加置换治疗的患者非常有用，如体表面积大的患者、怀疑有残余综合征的患者或长期接受透析且希望预防淀粉样变的患者。在线HDF安全且比传统血液透析耐受性更好。
