Department of Clinical Engineering, Tajirigaoka Hospital, Medical Cooperation Aiseikai, Hitachi, Japan,
Department of Clinical Engineering, Tajirigaoka Hospital, Medical Cooperation Aiseikai, Hitachi, Japan.
Blood Purif. 2019;48 Suppl 1:17-21. doi: 10.1159/000503876. Epub 2019 Nov 21.
Intermittent infusion hemodiafiltration -(I-HDF) has been performed for a number of years since this mode of dialysis became available with dialyzers used in Japan. It has been effective in some cases and ineffective in others. In this study, we analyzed and clarified these differences.
We conducted a retrospective study to determine the factors affecting the effectiveness of I-HDF treatment in some patients and ineffectiveness in others and classified the complex causes associated with volume load that were identified. Key Messages: Bolus dialysate infusion in I-HDF affects the volume load (preload), and repeated bolus dialysate infusion influences both preload and afterload in patients with valvular heart disease. In this study, I-HDF was effective when brain natriuretic peptide levels, cardiothoracic ratio, and ultrafiltration rate were well controlled and cardiac load was low. I-HDF was shown to be effective in patients who are prone to developing hypotension at the end of a dialysis session. There were several factors, including different types of load, involved in inefficiency of I-HDF.
自从日本开始使用透析器提供间歇性输注血液透析滤过(I-HDF)以来,这种透析模式已经使用了多年。在某些情况下它是有效的,而在其他情况下则无效。在这项研究中,我们分析并阐明了这些差异。
我们进行了一项回顾性研究,以确定影响某些患者 I-HDF 治疗效果的因素和其他患者无效的因素,并对与容量负荷相关的复杂原因进行了分类。
I-HDF 中的推注式透析液输注会影响容量负荷(前负荷),并且在瓣膜性心脏病患者中,重复的推注式透析液输注会同时影响前负荷和后负荷。在这项研究中,当脑利钠肽水平、心胸比和超滤率得到良好控制且心脏负荷较低时,I-HDF 是有效的。I-HDF 对在透析结束时容易发生低血压的患者有效。I-HDF 无效的原因有几个,包括不同类型的负荷。