Ton That H, Ibos R, Dupré C, Durand D
Service de néphrologie-hémodialyse, CHU Rangueil, Toulouse.
Rev Prat. 1991 Apr 21;41(12):1072-9.
During the last few years much progress has been achieved in extrarenal blood purification, notably since continuous dialysis techniques have been developed. All forms of acute renal failure can now be treated specifically and safely. Conventional haemodialysis is still widely used, particularly when acute renal failure is of long duration or when it occurs in a context of renal disease. Continuous blood purification is in full development: it is relatively easy to perform, well tolerated in terms of haemodynamics and better than haemodialysis in modulating fluid subtraction. It has become the method of choice in high-risk patients, notably elderly people or subjects with multiple visceral impairment. These advances have made it possible to treat efficiently a greater number of patients, but the benefit obtained must be evaluated in relation to a prognosis which is still determined by the acute renal failure. When several organs are involved, the mortality rate is above sixty percent.
在过去几年中，肾外血液净化取得了很大进展，尤其是自从连续透析技术发展以来。现在所有形式的急性肾衰竭都能得到针对性且安全的治疗。传统血液透析仍被广泛使用，特别是当急性肾衰竭病程较长或发生在肾病背景下时。连续性血液净化正在全面发展：它操作相对容易，血流动力学耐受性良好，在调节液体清除方面优于血液透析。它已成为高危患者，尤其是老年人或有多脏器损害患者的首选治疗方法。这些进展使得能够更有效地治疗更多患者，但所获得的益处必须根据仍由急性肾衰竭决定的预后进行评估。当多个器官受累时，死亡率超过60%。
