Renal Institute of Birmingham, University of Birmingham, University Hospital Birmingham, United Kingdom.
Adv Chronic Kidney Dis. 2011 May;18(3):180-7. doi: 10.1053/j.ackd.2011.02.006.
The removal of larger uremic toxins by conventional dialysis membranes is restricted by their molecular weight cut-offs. The recent availability of a new generation of hemodialysis membranes with molecular weight cut-offs closer to that of the native kidney (65 kDa) has led to work assessing their potential utility across several different clinical scenarios. Initially designed to remove proinflammatory cytokines in patients with severe sepsis syndrome, clinicians are now using these membranes for the treatment of myeloma kidney and rhabdomyolysis. Further early pilot studies have demonstrated a potential utility for the removal of larger middle molecules in the population with end-stage renal failure. The purpose of this review was to summarize the current evidence base for the use of high cut-off hemodialysis membranes and discuss their future clinical relevance.
传统透析膜去除较大的尿毒症毒素受到其分子量截止值的限制。最近出现的新一代血液透析膜的分子量截止值更接近天然肾脏（65 kDa），这促使人们在多种不同的临床情况下评估其潜在的用途。这些膜最初是为了去除严重败血症综合征患者中的促炎细胞因子而设计的，现在临床医生正在将其用于治疗骨髓瘤肾病和横纹肌溶解症。进一步的早期试点研究表明，在终末期肾衰竭患者中去除较大的中等分子具有潜在的用途。本文综述了使用高通量血液透析膜的现有证据基础，并讨论了其未来的临床相关性。
