Division of Nephrology, Dialysis and Renal Transplantation, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Nephrology School, Milano-Bicocca University, Milan, Italy.
Blood Purif. 2018;45(4):334-342. doi: 10.1159/000487123. Epub 2018 Feb 16.
Short frequent dialysis with NxStage System One cycler (NSO) has become increasingly popular as home hemodialysis prescription. Short dialysis sessions with NSO might not allow adequate phosphate (P) removal.
Single-session and weekly balances of P and calcium (Ca) were compared in 14 patients treated with NSO (6 sessions/week) and in 14 patients on standard bicarbonate dialysis (BHD).
NSO and BHD showed similar plasma P fall, with end-dialysis plasma P slightly lower in BHD (2.2 ± 0.5 vs. 2.7 ± 0.8 mg/dL, p < 0.02). Single-session P removal was lower in NSO, but weekly removal was higher (3,488 ± 1,181 mg vs. 2,634 ± 878, p < 0.003). Plasma Ca increase was lower in NSO, with similar PTH fall. Ca balance varied according to start plasma Ca, dialysate to blood Ca gradient and net ultrafiltration.
short, frequent home hemodialysis with NSO, on a 6/week-based prescription, allows higher weekly P removal than BHD. With the dialysate Ca concentration in use (6 mg/dL), total plasma Ca and iCa concentration increase is lower in NSO.
使用 NxStage System One 循环机（NSO）进行短而频繁的透析已成为家庭血液透析处方的首选。但是，NSO 的短透析疗程可能无法充分清除磷酸盐（P）。
比较了 14 名接受 NSO（每周 6 次）治疗的患者和 14 名接受标准碳酸氢盐透析（BHD）的患者单次和每周的 P 和钙（Ca）平衡。
NSO 和 BHD 显示出相似的血浆 P 下降，BHD 的终末期血浆 P 略低（2.2 ± 0.5 vs. 2.7 ± 0.8 mg/dL，p < 0.02）。NSO 的单次 P 清除率较低，但每周清除率较高（3,488 ± 1,181 mg vs. 2,634 ± 878，p < 0.003）。NSO 中的血浆 Ca 增加较低，同时 PTH 下降也相似。Ca 平衡取决于起始血浆 Ca、透析液至血液 Ca 梯度和净超滤。
在每周 6 次的基础上，使用 NSO 进行短而频繁的家庭血液透析，可以比 BHD 更高的每周 P 清除率。在使用的透析液 Ca 浓度（6 mg/dL）下，NSO 中的总血浆 Ca 和 iCa 浓度增加较低。
