University of Lyon, CarMeN, INSERM U1060, INSA de Lyon, Université Claude Bernard Lyon 1, INRA U1397, Villeurbanne, France.
Department of Nephrology, Hospices Civils de Lyon, Hôpital E. Herriot, Lyon, France.
Nephrol Dial Transplant. 2018 Oct 1;33(suppl_3):iii48-iii52. doi: 10.1093/ndt/gfy203.
Expanded haemodialysis (HDx) has emerged as a promising solution to improve haemodialysis effectiveness. A medium cut-off membrane allows the removal of a wider range of uraemic toxins. However, little is known about the potential interesting applications of HDx therapy. Feedback from the first routine use of HDx therapy under real-life conditions in European facilities was excellent for priming and rinse back. There was no adverse event after 5191 HDx treatments. Patients suffering from itching, restless legs syndrome, persistent asthenia or malnourishment could benefit from HDx therapy. Moreover, we discuss here the promising applications in which HDx could be valuable (myeloma, rhabdomyolysis or cardiovascular diseases). This enthusiastic message is mitigated by reminding why and how prudence should be taken in the design of future HDx studies.
扩展血液透析（HDx）已成为一种提高血液透析效果的有前途的解决方案。中分子截留膜允许更广泛范围的尿毒症毒素的清除。然而，对于 HDx 治疗的潜在有趣应用知之甚少。在欧洲医疗机构中根据实际情况首次常规使用 HDx 治疗的反馈在预充和冲洗回路上非常出色。在 5191 次 HDx 治疗后没有发生不良事件。患有瘙痒、不宁腿综合征、持续乏力或营养不良的患者可能从 HDx 治疗中受益。此外，我们在这里讨论了 HDx 可能具有价值的有前途的应用（骨髓瘤、横纹肌溶解或心血管疾病）。这一令人振奋的消息因提醒人们在设计未来的 HDx 研究时为何以及如何谨慎而有所缓和。
