Lapeyronie University Hospital, CHU Montpellier, France.
Blood Purif. 2010;29(4):366-74. doi: 10.1159/000309422. Epub 2010 Apr 14.
Recent surveys of hemodialysis studies strongly support the fact that dialysis prescription is a modifiable risk factor. Six tracks to improve dialysis patient outcomes have been identified: change in vascular access option strategy and restricting catheter use; increasing time or frequency of dialysis sessions; assessment and management of fluid status; favoring removal of middle and large molecules by high-flux and convective clearance; considering ultrapurity of dialysis fluid purity as a new standard and a part of hemodialysis biocompatibility, and improving quality care and patient follow-up. By modifying dialysis prescription and by implementing a continuous quality assurance program it appears possible to improve dialysis patient survival.
最近对血液透析研究的调查强烈支持这样一个事实,即透析方案是一个可改变的危险因素。已经确定了改善透析患者预后的六个途径:改变血管通路选择策略和限制导管使用;增加透析治疗次数或频率;评估和管理液体状态;通过高通量和对流清除来优先清除中大分子;考虑透析液纯度的超纯作为新的标准和血液透析生物相容性的一部分;以及改善护理质量和患者随访。通过修改透析方案和实施持续质量保证计划,似乎有可能提高透析患者的生存率。