Masakane Ikuto
Yabuki Shima Clinic, Yamagata, Japan.
Contrib Nephrol. 2011;173:84-94. doi: 10.1159/000328959. Epub 2011 Aug 8.
The golden target for dialysis therapy should be to guarantee longer survival and to give a higher quality of life without dialysis-related complications. In order to achieve this target, the choice of dialysis modality and membrane is essential but we have not yet established what the best choice for a dialysis modality and membrane are. Generally, we choose a dialysis modality for better solute removal and better biocompatibility. In this issue we would like to propose that the patients' preference for dialysis therapy is a useful parameter in prescribing the dialysis modality. In our recent experience, chronic dialysis patients have had preferences on a dialysis modality and membrane, those being PMMA, EVAL, AN-69 and pre-dilution online HDF. These modalities could relieve them of uncomfortable dialysis-related symptoms such as insomnia, itchiness, irritability, and so on. Other characteristics of these modalities are of a nutritional advantage, a broad removal pattern of uremic toxins including low-molecular-weight protein and protein-bound uremic toxins, and good biocompatibility free from chemical components of dialysis membrane. In conclusion, patients' symptoms could be a useful parameter to choose a dialysis modality and membrane.
透析治疗的黄金目标应该是确保更长的生存期，并在无透析相关并发症的情况下提供更高的生活质量。为了实现这一目标，透析方式和透析膜的选择至关重要，但我们尚未确定透析方式和透析膜的最佳选择是什么。一般来说，我们选择透析方式是为了更好地清除溶质和获得更好的生物相容性。在本期中，我们想提出患者对透析治疗的偏好是规定透析方式时一个有用的参数。根据我们最近的经验，慢性透析患者对透析方式和透析膜有偏好，这些方式和膜包括聚甲基丙烯酸甲酯（PMMA）、乙烯-乙烯醇共聚物（EVAL）、AN-69和前稀释在线血液透析滤过（HDF）。这些方式可以缓解他们与透析相关的不适症状，如失眠、瘙痒、易怒等。这些方式的其他特点包括营养优势、对尿毒症毒素（包括低分子量蛋白质和蛋白结合尿毒症毒素）的广泛清除模式，以及不含透析膜化学成分的良好生物相容性。总之，患者的症状可能是选择透析方式和透析膜的一个有用参数。
