Department of Nephrology, Hospital Universitari General de Castellón, Avinguda de Benicàssim, 128, 12004, Castellón de la Plana, Spain.
Universidad Politécnica de Madrid, Madrid, Spain.
Int Urol Nephrol. 2020 May;52(5):977-980. doi: 10.1007/s11255-020-02455-5. Epub 2020 Apr 15.
Among the different hemodialysis (HD) strategies, the short daily hemodialysis performed at home (SDHHD) provides clinical benefits to the patient. Expanded hemodialysis (HDx) employs cutoff medium membranes that exhibit greater clearance capacity of uremic toxins of medium-high molecular weight. This case series study reported the results of seven patients who were transferred to expanded hemodialysis at home (HHDx), from December 2017 to March 2019, over a 12-month follow-up period. The AK-98 monitor and Theranova 400 membrane (Baxter International Inc., Deerfield, IL, USA) were used. The main outcome measures were blood analytical values and drug consumption. The blood levels of β2-microglobulin were significantly reduced (p = 0.0082), while maintaining albumin levels with less use of phosphorus binders. Regarding the safety profile, technique-related adverse events were not reported. According to the results of the current study, HHDx was a safe technique, which additionally had the ability to provide benefits to patients due to its greater purification capacity. Further studies, especially multicenter ones, with a greater number of patients are needed to confirm these results.
在不同的血液透析（HD）策略中，在家进行的短时间每日血液透析（SDHHD）为患者提供了临床益处。扩展血液透析（HDx）采用中截留膜，具有更高的中高分子量尿毒症毒素的清除能力。本病例系列研究报告了 7 名患者从 2017 年 12 月至 2019 年 3 月在 12 个月的随访期间转至在家进行的扩展血液透析（HHDx）的结果。使用了 AK-98 监测仪和 Theranova 400 膜（Baxter International Inc.，美国 Deerfield）。主要观察指标是血液分析值和药物消耗。β2-微球蛋白的血液水平显著降低（p=0.0082），同时白蛋白水平保持不变，磷结合剂的使用量减少。关于安全性概况，未报告与技术相关的不良事件。根据当前研究的结果，HHDx 是一种安全的技术，由于其更高的净化能力，还能够为患者带来益处。需要进行更多的研究，特别是多中心研究，以增加患者数量，来证实这些结果。
