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绿色透析:让我们谈谈透析液。

Green Dialysis: Let Us Talk about Dialysis Fluid.

机构信息

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

Fresenius Nephrocare Polska sp. z o.o., Poznan, Poland.

出版信息

Kidney Blood Press Res. 2023;48(1):385-391. doi: 10.1159/000530439. Epub 2023 Apr 25.

Abstract

BACKGROUND

Hemodialysis is one of the most resources consuming medical intervention. Due to its concept, the proper amount of dialysis fluid passed through dialyzer is crucial to obtain the expected outcomes. The most frequent source of dialysis fluid is production from liquid concentrate (delivered in containers or plastic bags) in dialysis machine. Alternatively, concentrates for dialysis may be produced in dialysis center by dilution in mixing devices dry or semidry premixed compounds connected with system of central dialysis fluid delivery system. Dialysate consumption depends on various factors like type of hemodialysis machine, session duration, prescribed flow, etc. Summary: Modern hemodialysis machines are equipped with the modules which automatically reduce flow rate of dialysis fluid to the patient blood flow and minimize dialysate consumption during preparation and after reinfusion. Smart using of available options offered by manufacturers allows to save additional portion of acid concentrate and water. The weight of concentrates to be delivered to the dialysis center is the major factor influencing the cost (financial and environmental) of transportation from the manufacturer to the final consumer. The crisis on the energy carriers market and extremely high fuel prices made the transportation cost one of the significant costs of the treatment, which must be bear by supplier and finally influence on the price of goods.

KEY MESSAGES

The careful choice of the concentrate delivery system can improve cost-effectiveness of dialysis. Such solutions implemented in dialysis unit helps make significant savings and decrease the impact on natural environment by carbon footprint reduction.

摘要

背景

血液透析是最耗费资源的医疗干预措施之一。由于其概念,通过透析器的适当透析液量对于获得预期结果至关重要。透析液最常见的来源是在透析机中由液体浓缩物(以容器或塑料袋形式提供)生产。或者,透析液浓缩物可以在透析中心通过在混合设备中稀释干粉或半干粉预混化合物,并与中央透析液输送系统连接来生产。透析液消耗取决于各种因素,如血液透析机的类型、治疗时间、规定的流速等。总结:现代血液透析机能自动降低透析液流量到患者血流,从而在准备和再输注过程中最小化透析液消耗。明智地使用制造商提供的可用选项可以节省额外的酸浓缩物和水。需要输送到透析中心的浓缩物的重量是影响从制造商到最终消费者的运输成本(财务和环境)的主要因素。能源载体市场的危机和极高的燃料价格使得运输成本成为治疗的重要成本之一,供应商必须承担这些成本,最终影响商品价格。

关键信息

仔细选择浓缩物输送系统可以提高透析的成本效益。在透析单位实施此类解决方案有助于节省大量资金,并通过减少碳足迹来减少对自然环境的影响。

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本文引用的文献

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Carbon footprint of a hemodialysis unit in Morocco.摩洛哥一家血液透析单位的碳足迹
Ther Apher Dial. 2021 Oct;25(5):613-620. doi: 10.1111/1744-9987.13607. Epub 2020 Dec 14.
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Water use in dialysis: environmental considerations.透析中的用水:环境考量
Nat Rev Nephrol. 2020 Oct;16(10):556-557. doi: 10.1038/s41581-020-0296-3.
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Eco-dialysis: fashion or necessity.生态透析:时尚还是必需。
Int Urol Nephrol. 2020 Mar;52(3):519-523. doi: 10.1007/s11255-020-02393-2. Epub 2020 Feb 1.

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