Department of Nephrology, Hospital Universitario Reina Sofía, Córdoba, Spain.
Ren Fail. 2011;33(8):765-9. doi: 10.3109/0886022X.2011.599912. Epub 2011 Jul 20.
Hemodialysis (HD) and plasmapheresis (PE) are usually performed independently on patients who require renal replacement therapy. We analyzed our experience using a technique that performs both modalities simultaneously.
Thirty-six patients who were treated with 287 tandem PE and HD (TPH) sessions (mean 7.97 ± 5.6 per patient) were included. PE was connected 30 min after HD started. The mean HD blood flow was 313.7 ± 44 mL/min, the mean PE blood flow was 141 ± 25 mL/min, and the duration of TPH was no longer than 240 min. The heparin dose was similar to that used for a standard HD procedure.
In 287 TPH sessions performed, 10.45% experienced minor complications. There were significant changes in mean blood pressure after connection of the PE system. However, these differences were not clinically relevant since patients remained asymptomatic and they did not require saline infusion. At the end of treatment, 38.9% of patients were no longer dependent on dialysis.
Our results suggest that TPH is a safe and effective treatment that decreases exposure to an extracorporeal circuit, reducing the risks that are associated with anticoagulation agents and improving the comfortability of the patient.
血液透析（HD）和血浆置换（PE）通常是为需要肾脏替代治疗的患者独立进行的。我们分析了同时进行这两种治疗模式的经验。
共纳入 36 例接受 287 次串联血浆置换和血液透析（TPH）治疗的患者（平均每人 7.97±5.6 次）。PE 在 HD 开始后 30 分钟连接。HD 的平均血流为 313.7±44mL/min，PE 的平均血流为 141±25mL/min，TPH 的持续时间不超过 240min。肝素剂量与标准 HD 程序相同。
在进行的 287 次 TPH 治疗中，10.45%出现轻微并发症。连接 PE 系统后，平均血压有显著变化。然而，这些差异在临床上并不重要，因为患者无症状且不需要生理盐水输注。治疗结束时，38.9%的患者不再依赖透析。
我们的结果表明，TPH 是一种安全有效的治疗方法，可减少对体外回路的暴露，降低与抗凝剂相关的风险，并提高患者的舒适度。
