Fischbach M, Mengus L, Simeoni U, Duringer R, Mark J, De Geeter B, Hamel G, Geisert J
Laboratoire de Biochimie, Hôpital de Hautepierre, Strasbourg.
Nephrologie. 1991;12(4):179-83.
Despite significant technical improvements (bicarbonate dialysate, volumetric ultrafiltration control) high intradialytic ultrafiltration is troublesome in children, specially in the proportion of patients presenting a normal or low blood pressure even with overweight. We used, in this group of children (overhydratated without vascular repercution) a modelling of both sodium and ultrafiltration during dialysis, in order to achieve dry body weight without increasing session time despite hypotension risks. The usefulness and practicability of sodium and ultrafiltration modelling together during dialysis in children is analysed in a short time study (for plasma volume changes calculation) and in a long term follow up study over a year (for clinical tolerance). Today, we reserve this form of dialysis only for a single session needed by overhydratation (more than 5% of dry body weight) in order to achieve dry body weight maintaining dialysis session time constant without increasing side effects (hypotension).
尽管有显著的技术改进(碳酸氢盐透析液、容量超滤控制),但高透析内超滤在儿童中仍然很麻烦,特别是在即使超重但血压正常或偏低的患者比例中。在这组儿童(水合过多但无血管影响)中,我们在透析期间对钠和超滤进行建模,以便在不增加透析时间的情况下达到干体重,尽管存在低血压风险。在一项短期研究(用于计算血浆容量变化)和一项为期一年的长期随访研究(用于临床耐受性)中分析了儿童透析期间钠和超滤联合建模的有效性和实用性。如今,我们仅将这种透析形式用于因水合过多(超过干体重的5%)而需要的单次透析,以达到干体重,同时保持透析时间不变且不增加副作用(低血压)。