Ng Tsun G, Johnson David W, Hawley Carmel M
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Nephrology (Carlton). 2007 Jun;12(3):209-17. doi: 10.1111/j.1440-1797.2007.00795.x.
Residual renal function (RRF) is not currently emphasized for patients undergoing haemodialysis (HD). The role of RRF is well recognized in the peritoneal dialysis population as studies have clearly demonstrated a survival benefit with preservation of RRF. There is however, data to suggest that RRF is important in HD patients as well. Contemporary HD therapies using high flux biocompatible synthetic dialysers, bicarbonate buffered ultrapure dialysis fluids with ultrafiltration control appear to allow better preservation of RRF. The long held belief that peritoneal dialysis is better at preserving RRF than HD may no longer be true. More robust studies are required to determine the relative importance of RRF in HD and strategies to best preserve this vital asset.
目前,残余肾功能(RRF)在接受血液透析(HD)的患者中未得到重视。RRF在腹膜透析人群中的作用已得到充分认可,因为研究已清楚表明保留RRF可带来生存益处。然而,有数据表明RRF在HD患者中也很重要。使用高通量生物相容性合成透析器、具有超滤控制的碳酸氢盐缓冲超纯透析液的当代HD疗法似乎能更好地保留RRF。长期以来认为腹膜透析在保留RRF方面比HD更好的观点可能不再成立。需要更有力的研究来确定RRF在HD中的相对重要性以及最佳保留这一重要资产的策略。