Kosmadakis George, Correia Enrique Da Costa, Somda Frederic, Aguilera Didier
Metabolic Pole and Hemodialysis Unit, Jacques Lacarin General Hospital, Vichy, France.
Saudi J Kidney Dis Transpl. 2017 May-Jun;28(3):558-565. doi: 10.4103/1319-2442.206436.
Intradialytic hypotensive episodes are deleterious for hemodialysis (HD) patients. Acetate-free biofiltration with profiled potassium (AFBK) dialysate concentration may improve their cardiovascular stability. The aim of the present crossover study was to compare intradialytic hemodynamic tolerance and biological parameters between online hemodiafiltration (olHDF) and AFBK. Ten frail HD patients (8 males) with a mean age of 66.71- ± 12.31 years were studied for three months on olHDF and AFBK. There was a significant reduction of the hypotensive episodes during the AFBK period compared to the olHDF period. Mean intradialytic systolic and diastolic blood pressures were significantly higher during the AFBK period. There was a significant postdialytic increase in serum sodium concentration with the AFBK compared to olHDF. The dry weight and ultrafiltration indices were significantly higher, and the Kt/V was significantly lower during the AFBK period. Serum albumin concentration significantly increased during the AFBK period. AFBK leads to a significantly improved intradialytic tolerance in hemodynamically instable HD patients.
透析期间的低血压发作对血液透析（HD）患者有害。采用含钾量呈曲线变化的无醋酸盐生物滤过（AFBK）透析液浓度可能会改善患者的心血管稳定性。本交叉研究的目的是比较在线血液透析滤过（olHDF）和AFBK之间的透析期间血流动力学耐受性及生物学参数。对10例体弱的HD患者（8例男性）进行了为期三个月的研究，这些患者平均年龄为66.71±12.31岁，分别接受olHDF和AFBK治疗。与olHDF治疗期相比，AFBK治疗期的低血压发作显著减少。AFBK治疗期透析期间的平均收缩压和舒张压显著更高。与olHDF相比，AFBK治疗后血清钠浓度有显著升高。AFBK治疗期的干体重和超滤指数显著更高，而Kt/V显著更低。AFBK治疗期血清白蛋白浓度显著升高。AFBK可显著改善血流动力学不稳定的HD患者的透析期间耐受性。
