Gagnon R F, Kaye M
Clin Nephrol. 1985 Jul;24(1):21-7.
Studies were performed in patients on maintenance hemodialysis to evaluate the role of prolonged dialyzer reuse in the management of end-stage renal disease. For this purpose the patients were dialyzed without interruption with the same hollow fiber dialyzers (GambroR 120M) reprocessed with the Lixivitron IIR equipment. The data obtained from in vivo clearances in sixteen patients demonstrate that membrane permeability to small solutes (urea, creatinine, phosphate) is maintained up to thirty dialyzer uses. In vitro studies confirmed this observation and established that clearances of larger solutes (vitamin B12) are also maintained over similar extensive dialyzer reuse. Hematological and blood gas studies were performed serially during dialysis in five additional patients. Although circulating leucocyte and neutrophil counts, hemoglobin concentration as well as arterial pH and partial pressures of oxygen and carbon dioxide changed appropriately during dialysis, there was no observable difference from the first to the twentieth use of the same dialyzer. Thus, these results clearly demonstrate that prolonged dialyzer reuse in end-stage renal disease patients constitutes a stable form of renal replacement therapy provided adequate dialyzer reprocessing is applied.
对维持性血液透析患者进行了研究,以评估延长透析器复用在终末期肾病治疗中的作用。为此,使用Lixivitron IIR设备对相同的中空纤维透析器(Gambro R 120M)进行再处理后,对患者进行不间断透析。从16名患者的体内清除率获得的数据表明,膜对小溶质(尿素、肌酐、磷酸盐)的通透性在透析器使用30次之前保持不变。体外研究证实了这一观察结果,并确定在类似的长时间透析器复用过程中,大溶质(维生素B12)的清除率也能维持。另外5名患者在透析期间连续进行了血液学和血气研究。尽管在透析过程中循环白细胞和中性粒细胞计数、血红蛋白浓度以及动脉pH值、氧分压和二氧化碳分压有适当变化,但同一透析器从第一次使用到第二十次使用时,未观察到明显差异。因此,这些结果清楚地表明,只要进行适当的透析器再处理,终末期肾病患者延长透析器复用是一种稳定的肾脏替代治疗形式。