Sobaszek-Pitas Magdalena, Kopeć Jerzy, Krzanowski Marcin, Sułowicz Władysław
Przegl Lek. 2014;71(7):384-8.
Hemodialysis (HD) is a dynamic process, which occurs during movement through a semipermeable membrane, water soluble substances of low molecular weight. Transport across the membranes of low-flux (LF) dialyzers is based mainly on diffusion and through the membranes of high-flux (HF) dialyzers, diffusion and convection. The aim of the study was to compare the adequacy of hemodialyses conducted on the basis of the low-flux dialyzers with polysulfone membrane, and the high-flux dialyzers with helixone membrane.
The study included 60 patients (23 women and 37 men) aged 24-84 years (mean 60.73 +/- 15.75) treated with maintenance hemodialysis (three times per week). The study enrolled clinically stable patients after a minimum 3-months period of HD. Blood tests were performed 1 time a month before the middle week dialysis session. For the first six months HD was based on LF dialyzers with polysulfone membrane, and then for an additional 6 months based on HF dialyzers with helixone membrane.
The performed study demonstrated a statistically significant higher values of: spKtV and URR% and lower values of the urea before and after HD sessions performed based on HF-HD as compared with LF-HD (spKt/V LF = 1.26 +/- 0.23 vs. spKtV HF = 1.37 +/- 0.17; p < 0.001, URR% LF = 66.74 +/- 5.86 vs. URR% HF = 70.57 +/- 3.71; p < 0.001, urea before LF-HD = 21.57 +/- 4.57 mmol/I vs. HF-HD = 20.57 +/- 4.21 mmol/I; p < 0.01 and the urea after LF. HD = 7.19 +/- 2.25 mmol/l vs. HF-HD = 6.03 +/- 1.55 mmol/l; p < 0.001). Conclusions: The study showed better adequacy of HD treatment performed based on the high-flux dialyzers with helixone membrane as compared with low-flux dialyzers with polysulfone membrane.
血液透析（HD）是一个动态过程，发生在通过半透膜移动期间，涉及低分子量的水溶性物质。低通量（LF）透析器膜的转运主要基于扩散，而高通量（HF）透析器膜的转运则基于扩散和对流。本研究的目的是比较基于聚砜膜的低通量透析器和基于螺旋膜的高通量透析器进行血液透析的充分性。
该研究纳入了60例年龄在24 - 84岁（平均60.73±15.75）的患者（23名女性和37名男性），接受维持性血液透析（每周三次）。该研究纳入了至少经过3个月血液透析且临床稳定的患者。在透析中间周的前一个月进行一次血液检测。前六个月的血液透析基于聚砜膜的低通量透析器，然后再额外6个月基于螺旋膜的高通量透析器。
所进行研究表明，与低通量血液透析（LF - HD）相比（LF - HD的spKt/V = 1.26±0.23，而HF - HD的spKtV = 1.37±0.17；p < 0.001，LF - HD的URR% = 66.74±5.86，而HF - HD的URR% = 70.57±3.71；p < 0.001，LF - HD前的尿素 = 21.57±4.57 mmol/I，而HF - HD的尿素 = 20.57±4.21 mmol/I；p < 0.01，LF - HD后的尿素 = 7.19±2.25 mmol/l，而HF - HD的尿素 = 6.03±1.55 mmol/l；p < 0.001），基于高通量血液透析（HF - HD）进行的透析过程中，spKtV和URR%的值在统计学上显著更高，而透析前后的尿素值更低。结论：该研究表明，与基于聚砜膜的低通量透析器相比，基于螺旋膜的高通量透析器进行的血液透析治疗充分性更好。
