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生态透析:时尚还是必需。

Eco-dialysis: fashion or necessity.

机构信息

Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

Fresenius Medical Care Polska S.A., Poznan, Poland.

出版信息

Int Urol Nephrol. 2020 Mar;52(3):519-523. doi: 10.1007/s11255-020-02393-2. Epub 2020 Feb 1.

DOI:10.1007/s11255-020-02393-2
PMID:32008203
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7060957/
Abstract

Hemodialysis (HD) is one of the resource hungry medical interventions. A huge volume of water (about 500 L) and significant amounts of energy (over 7 kW) are used for a hemodialysis session; over a kilogram of waste is produced during this procedure. Thus, HD contributes to global warming while saving patients' lives. In this paper, we showed these crucial points in HD treatment and possible ways (e.g. modifications in dialysate flow rate) to reduce environmental impact maintaining therapy standards.

摘要

血液透析(HD)是一种资源密集型的医疗干预措施。一次血液透析 session 需要使用大量的水(约 500 升)和大量的能量(超过 7 千瓦);在此过程中会产生超过一公斤的废物。因此,HD 在拯救患者生命的同时也导致了全球变暖。在本文中,我们展示了 HD 治疗中的这些关键点,以及在保持治疗标准的同时,减少环境影响的可能方法(例如改变透析液流速)。

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Eco-dialysis: fashion or necessity.生态透析:时尚还是必需。
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2
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Quantitative assessment of sodium mass removal using ionic dialysance and sodium gradient as a proxy tool: Comparison of high-flux hemodialysis versus online hemodiafiltration.使用离子透析和钠梯度作为替代工具定量评估钠质量去除:高通量血液透析与在线血液透析滤过的比较。
Artif Organs. 2021 Aug;45(8):E280-E292. doi: 10.1111/aor.13923. Epub 2021 Mar 8.
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Effects of dialysate to serum sodium (Na) alignment in chronic hemodialysis (HD) patients: retrospective cohort study from a quality improvement project.慢性血液透析(HD)患者中透析液与血清钠(Na)匹配的效果:一项质量改进项目的回顾性队列研究
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本文引用的文献

1
Global prevalent use, trends and practices in haemodiafiltration.全球普遍使用、趋势和血液透析滤过的实践。
Nephrol Dial Transplant. 2020 Mar 1;35(3):398-407. doi: 10.1093/ndt/gfz005.
2
Blue Planet dialysis: novel water-sparing strategies for reducing dialysate flow.蓝色星球透析:减少透析液流量的新型节水策略。
Int J Artif Organs. 2017 Nov 8:0. doi: 10.5301/ijao.5000660.
3
Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly.与高通量血液透析相比,老年患者对在线血液透析滤过的治疗耐受性和患者报告结局更好。
Kidney Int. 2017 Jun;91(6):1495-1509. doi: 10.1016/j.kint.2017.01.013. Epub 2017 Mar 18.
4
KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 update.KDOQI 临床实践指南:血液透析充分性 2015 年更新版。
Am J Kidney Dis. 2015 Nov;66(5):884-930. doi: 10.1053/j.ajkd.2015.07.015.
5
Is it useful to increase dialysate flow rate to improve the delivered Kt?增加透析液流速以提高透析剂量(Kt)是否有用?
BMC Nephrol. 2015 Feb 14;16:20. doi: 10.1186/s12882-015-0013-9.
6
Eco-dialysis: the financial and ecological costs of dialysis waste products: is a 'cradle-to-cradle' model feasible for planet-friendly haemodialysis waste management?生态透析:透析废物的经济和生态成本:“从摇篮到摇篮”模型是否适用于对地球友好的血液透析废物管理?
Nephrol Dial Transplant. 2015 Jun;30(6):1018-27. doi: 10.1093/ndt/gfv031. Epub 2015 Mar 24.
7
Worldwide access to treatment for end-stage kidney disease: a systematic review.全球范围内终末期肾病治疗的可及性:一项系统评价。
Lancet. 2015 May 16;385(9981):1975-82. doi: 10.1016/S0140-6736(14)61601-9. Epub 2015 Mar 13.
8
Green dialysis: the environmental challenges ahead.绿色透析:未来的环境挑战。
Semin Dial. 2015 Mar-Apr;28(2):186-92. doi: 10.1111/sdi.12324. Epub 2014 Nov 30.
9
Effects of reduced dialysis fluid flow in hemodialysis.血液透析中透析液流量降低的影响
J Nippon Med Sch. 2013;80(2):119-30. doi: 10.1272/jnms.80.119.
10
High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients.高通量在线血液透析滤过降低血液透析患者全因死亡率。
J Am Soc Nephrol. 2013 Feb;24(3):487-97. doi: 10.1681/ASN.2012080875. Epub 2013 Feb 14.