Department of Nephrology, Monash Medical Centre and Monash University, Clayton, Victoria, Australia.
Am J Kidney Dis. 2011 Sep;58(3):461-70. doi: 10.1053/j.ajkd.2011.04.021. Epub 2011 Jul 23.
There are many variations in the delivery of hemodialysis. These variations include components of conventional dialysis, such as membrane type, dialysis dose, and session duration. In addition, alternative approaches to dialysis, such as hemodiafiltration, nocturnal hemodialysis, and short daily hemodialysis, also may be considered. For some of these practice variations, data exist to support one approach over another (eg, fistulas rather than grafts and catheters), but for many, no such data exist. Very few practice variations have been examined in randomized trials, and we are reliant predominantly on observational data. This review examines some practice variations in hemodialysis delivery, attempting to highlight which of these may be appropriate to consider when optimizing dialysis delivery in the clinic.
血液透析的实施方式有很多变化。这些变化包括常规透析的组成部分，如膜类型、透析剂量和治疗时间。此外，还可以考虑替代透析方法，如血液透析滤过、夜间血液透析和短时间每日血液透析。对于其中一些实践变化，有数据支持一种方法优于另一种方法（例如，瘘管而不是移植物和导管），但对于许多方法，没有这样的数据。只有少数实践变化在随机试验中得到了检查，我们主要依赖于观察性数据。本综述检查了血液透析实施中的一些实践变化，试图强调在临床优化透析实施时可能需要考虑的这些变化。
