Department of Medicine, Stanford University, Palo Alto, California.
Department of Medicine, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California.
Kidney360. 2021 Jul;2(7):1188-1195. doi: 10.34067/KID.0002922021.
The adequacy of hemodialysis is now assessed by measuring the removal of a single solute, urea. The urea clearance provided by current dialysis methods is a large fraction of the blood flow through the dialyzer, and, therefore, cannot be increased much further. However, other solutes, which are less effectively cleared than urea, may contribute more to the residual uremic illness suffered by patients on hemodialysis. Here, we review a variety of methods that could be used to increase the clearance of such nonurea solutes. New clinical studies will be required to test the extent to which increasing solute clearances improves patients' health.
目前，通过测量单一溶质（尿素）的清除率来评估血液透析的充分性。当前透析方法提供的尿素清除率是通过透析器的血流的很大一部分，因此不能进一步增加太多。然而，其他比尿素清除效率低的溶质可能会对接受血液透析的患者所患的残余尿毒症疾病有更大的影响。在这里，我们回顾了可以用来增加这些非尿素溶质清除率的各种方法。需要进行新的临床研究来测试增加溶质清除率在多大程度上改善患者的健康状况。
