Locatelli Francesco, La Milia Vincenzo, Violo Leano, Del Vecchio Lucia, Di Filippo Salvatore
Nephrology and Dialysis Department , 'Alessandro Manzoni' Hospital , Lecco , Italy.
Clin Kidney J. 2015 Oct;8(5):580-9. doi: 10.1093/ckj/sfv057. Epub 2015 Aug 8.
Survival and quality of life of dialysis patients are strictly dependent on the quality of the haemodialysis (HD) treatment. In this respect, dialysate composition, including water purity, plays a crucial role. A major aim of HD is to normalize predialysis plasma electrolyte and mineral concentrations, while minimizing wide swings in the patient's intradialytic plasma concentrations. Adequate sodium (Na) and water removal is critical for preventing intra- and interdialytic hypotension and pulmonary edema. Avoiding both hyper- and hypokalaemia prevents life-threatening cardiac arrhythmias. Optimal calcium (Ca) and magnesium (Mg) dialysate concentrations may protect the cardiovascular system and the bones, preventing extraskeletal calcifications, severe secondary hyperparathyroidism and adynamic bone disease. Adequate bicarbonate concentration [HCO3 (-)] maintains a stable pH in the body fluids for appropriate protein and membrane functioning and also protects the bones. An adequate dialysate glucose concentration prevents severe hyperglycaemia and life-threating hypoglycaemia, which can lead to severe cardiovascular complications and a worsening of diabetic comorbidities.
透析患者的生存和生活质量严格依赖于血液透析（HD）治疗的质量。在这方面，透析液的成分，包括水的纯度，起着至关重要的作用。血液透析的一个主要目标是使透析前血浆电解质和矿物质浓度正常化，同时尽量减少患者透析期间血浆浓度的大幅波动。充分清除钠（Na）和水对于预防透析期间和透析间期的低血压及肺水肿至关重要。避免高钾血症和低钾血症可预防危及生命的心律失常。最佳的钙（Ca）和镁（Mg）透析液浓度可保护心血管系统和骨骼，预防骨骼外钙化、严重的继发性甲状旁腺功能亢进和无动力性骨病。适当的碳酸氢盐浓度[HCO3(-)]可维持体液稳定的pH值，以保证蛋白质和膜的正常功能，还可保护骨骼。适当的透析液葡萄糖浓度可预防严重的高血糖症和危及生命的低血糖症，这些情况可导致严重的心血管并发症和糖尿病合并症的恶化。
