Abe Takaya, Onoda Mistutaka, Matsuura Tomohiko, Sugimura Jun, Obara Wataru, Sato Toshiya, Takahashi Mihoko, Chiba Kenta, Abe Tomiya
Department of Urology, School of Medicine, Iwate Medical University, 19-1, Uchimaru, Morioka, 020-8505, Japan.
Clinical Engineering Center, Iwate Medical University Hospital, 19-1, Uchimaru, Morioka, 020-8505, Japan.
J Artif Organs. 2017 Sep;20(3):230-235. doi: 10.1007/s10047-017-0953-x. Epub 2017 Mar 29.
An electrical or water supply and a blood purification machine are required for renal replacement therapy. There is a possibility that acute kidney injury can occur in large numbers and on a wide scale in the case of a massive earthquake, and there is the potential risk that the current supply will be unable to cope with acute kidney injury cases. However, non-machinery dialysis requires exclusive circuits and has the characteristic of not requiring the full-scale dialysis machines. We performed perfusion experiments that used non-machinery dialysis and recent blood purification machines in 30-min intervals, and the effectiveness of non-machinery dialysis was evaluated by the assessing the removal efficiency of potassium, which causes lethal arrhythmia during acute kidney injury. The non-machinery dialysis potassium removal rate was at the same level as continuous blood purification machines with a dialysate flow rate of 5 L/h after 15 min and continuous blood purification machines with a dialysate flow rate of 3 L/h after 30 min. Non-machinery dialysis required an exclusive dialysate circuit, the frequent need to replace bags, and new dialysate exchanged once every 30 min. However, it can be seen as an effective renal replacement therapy for crush-related acute kidney injury patients, even in locations or facilities not having the full-scale dialysis machines.
肾脏替代治疗需要电力或水源供应以及一台血液净化机器。在发生大规模地震的情况下，有可能大量且广泛地出现急性肾损伤，并且存在当前供应无法应对急性肾损伤病例的潜在风险。然而，非机器透析需要专用回路，其特点是不需要大型透析机器。我们每隔30分钟进行一次使用非机器透析和最新血液净化机器的灌注实验，并通过评估钾的清除效率来评价非机器透析的有效性，钾在急性肾损伤期间会导致致命性心律失常。非机器透析的钾清除率在15分钟后与透析液流速为5L/h的连续性血液净化机器相当，在30分钟后与透析液流速为3L/h的连续性血液净化机器相当。非机器透析需要专用的透析液回路，频繁需要更换袋子，并且每30分钟更换一次新的透析液。然而，即使在没有大型透析机器的地点或设施中，对于挤压伤相关的急性肾损伤患者，它也可被视为一种有效的肾脏替代治疗方法。
