Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Renal Medicine, Counties Manukau District Health Board, Auckland, New Zealand; Therapeutic Area, Baxter Healthcare (Asia) Pty. Ltd., Singapore.
Kidney Int. 2017 Jun;91(6):1279-1282. doi: 10.1016/j.kint.2017.02.024.
There is a strong biological plausibility for benefit from removal of larger uremic toxins and increasing positive clinical experience with hemodiafiltration. However, evidence supporting hemodiafiltration is not definitive with studies that are often limited by serious methodological shortcomings. Morena et al. show that hemodiafiltration may prevent intradialytic hypotension, albeit in a study that also has some shortcomings. Ongoing research for hemodiafiltration is still needed through high-quality clinical trials that adhere to standards for clinical trial conduct and reporting.
对于通过清除更大分子量的尿毒症毒素和增加血液透析滤过的正性临床经验而获益，有很强的生物学合理性。然而，支持血液透析滤过的证据并不明确，这些研究往往受到严重方法学缺陷的限制。Morena 等人表明，血液透析滤过可能预防透析中低血压，尽管这项研究也存在一些缺陷。仍需要通过遵循临床试验实施和报告标准的高质量临床试验，开展血液透析滤过的研究。
