McGill Rita L, Weiner Daniel E
Division of Nephrology, Tufts Medical Center, Boston, Massachusetts.
Semin Dial. 2017 Mar;30(2):112-120. doi: 10.1111/sdi.12573. Epub 2017 Jan 8.
Dialysate composition is a critical aspect of the hemodialysis prescription. Despite this, trial data are almost entirely lacking to help guide the optimal dialysate composition. Often, the concentrations of key components are chosen intuitively, and dialysate composition may be determined by default based on dialysate manufacturer specifications or hemodialysis facility practices. In this review, we examine the current epidemiological evidence guiding selection of dialysate bicarbonate, calcium, magnesium, and potassium, and identify unresolved issues for which pragmatic clinical trials are needed.
透析液成分是血液透析处方的一个关键方面。尽管如此,几乎完全缺乏试验数据来帮助指导最佳透析液成分的选择。通常,关键成分的浓度是凭直觉选择的,透析液成分可能默认根据透析液制造商的规格或血液透析机构的做法来确定。在本综述中,我们研究了目前指导透析液碳酸氢盐、钙、镁和钾选择的流行病学证据,并确定了需要进行务实临床试验的未解决问题。