Department of Nephrology, Hospital General "Dr. Miguel Silva", Morelia, Mexico,
Department of Research and Educational, NausLife Hemodialysis Clinics, Morelia, Mexico,
Blood Purif. 2020;49(1-2):197-201. doi: 10.1159/000504241. Epub 2019 Dec 18.
End-stage kidney disease (ESKD) is a worldwide unsolved problem. Access to renal replacement therapies (RRT) is still a challenge in some developed countries and even more so in developing countries. Allo-hemodialysis (alloHD) is a recently proposed, still hypothetical, alternative RRT where the blood of a healthy subject ("buddy") flows countercurrent to the patient's blood through the dialyzer. Solutes and fluid are transferred to the buddy and then cleared by his/her healthy kidneys, making alloHD essentially a procedure where the buddy "donates" kidney function intermittently to the patient. Its drastically reduced complexity makes -alloHD particularly attractive for low-resource settings. The acceptance of alloHD by patients, caregivers, and health care professionals (HCP) is unknown. In this cross-sectional study, we surveyed the preferences and acceptance of alloHD in 3 groups: caregivers related to ESKD patients, nonrelated caregivers (nrCG), and HCP. Four areas were explored: RRT preferences, kidney organ donation for transplant acceptance, -alloHD acceptance as a potential RRT, and alloHD technique acceptance. Hemodialysis was the preferred form of RRT. Kidney donation acceptance was similar in all groups. Intermittent kidney function donation (i.e., alloHD) was mainly accepted by related and nrCG but less accepted by HCP (87, 90, and 60% respectively, p < 0.01). New RRT alternatives such as alloHD are expected to be better received and accepted once animal, and clinical studies have demonstrated their feasibility, safety, and benefits. New RRT strategies are required primarily in most vulnerable populations and should be explored.
终末期肾病（ESKD）是一个全球性的未解决的问题。在一些发达国家，获得肾脏替代疗法（RRT）仍然是一个挑战，在发展中国家更是如此。异体血液透析（alloHD）是一种最近提出的、仍处于假设阶段的替代 RRT 方法，其中健康受试者（“供体”）的血液通过透析器与患者的血液逆流。溶质和液体被转移到供体，然后由他/她的健康肾脏清除，使 alloHD 本质上是一种供体间歇性“捐献”肾脏功能给患者的程序。其大大降低的复杂性使得 alloHD 在资源匮乏的环境中特别有吸引力。患者、护理人员和医疗保健专业人员（HCP）对 alloHD 的接受程度尚不清楚。在这项横断面研究中，我们调查了 3 组人群对 alloHD 的偏好和接受程度：ESKD 患者的护理人员、非亲属护理人员（nrCG）和 HCP。探讨了 4 个方面：RRT 偏好、用于移植的肾脏器官捐赠接受情况、作为潜在 RRT 的 alloHD 接受情况以及 alloHD 技术接受情况。血液透析是首选的 RRT 形式。所有组的肾脏捐赠接受情况相似。间歇性肾脏功能捐赠（即 alloHD）主要被相关和 nrCG 接受，但较少被 HCP 接受（分别为 87%、90%和 60%，p<0.01）。一旦动物和临床研究证明了其可行性、安全性和益处，预计像 alloHD 这样的新 RRT 替代方案将得到更好的接受和认可。新的 RRT 策略主要需要在大多数弱势群体中探索。
