Tang H L, Tang Candic M K, Chu K H, Lee W, Cheuk A, Yim K F, Fung K S, Chan Hilda W H, Tong K L
Division of Nephrology, Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong.
Hong Kong Med J. 2008 Oct;14(5):395-8.
We report our experience of the first use of nocturnal home haemodialysis in Hong Kong. The patient, a 40-year-old man with end-stage renal failure, was recruited into the Nocturnal Home Haemodialysis Programme at Princess Margaret Hospital in 2006. He received haemodialysis at home on alternate nights (3.5 sessions per week) for 5.5 to 6 hours per session. After 1 year of nocturnal home haemodialysis, his recombinant human erythropoietin requirement had been reduced by more than 50%. His serum phosphate level decreased by 35% and calcium phosphate product by 34%. After nocturnal home haemodialysis, his blood pressure control has been excellent and he was able to cease taking anti-hypertensive medications soon after commencing nocturnal home haemodialysis. Regression of his left ventricular hypertrophy has also been noted, with a 39% decrease in his left ventricular mass index. The haemodialysis adequacy index, weekly single-pool Kt/V, increased by 59% after switching to nocturnal home haemodialysis and his quality-of-life indices also showed significant improvement. Nocturnal home haemodialysis holds promise as an alternative dialytic therapy for patients on chronic haemodialysis in Hong Kong.
我们报告了香港首次使用夜间家庭血液透析的经验。该患者为一名40岁的终末期肾衰竭男性，于2006年被纳入玛嘉烈医院的夜间家庭血液透析项目。他每周隔天在家接受血液透析（每周3.5次），每次透析5.5至6小时。经过1年的夜间家庭血液透析，他对重组人促红细胞生成素的需求量减少了50%以上。他的血清磷酸盐水平下降了35%，钙磷乘积下降了34%。夜间家庭血液透析后，他的血压控制良好，在开始夜间家庭血液透析后不久就能够停止服用抗高血压药物。还注意到他的左心室肥厚有所消退，左心室质量指数下降了39%。改用夜间家庭血液透析后，血液透析充分性指标——每周单池Kt/V增加了59%，他的生活质量指标也有显著改善。夜间家庭血液透析有望成为香港慢性血液透析患者的一种替代透析治疗方法。
