Stefoni S, Feliciangeli G, Colì L, Prandini R, Bonomini V
Contrib Nephrol. 1982;29:123-32. doi: 10.1159/000406184.
The capacity of charcoal to absorb endogenous and exogenous toxins is well established. It removes substances of higher molecular weight than standard dialysis membranes. The regular use of charcoal hemoperfusion as an adjunct to hemodialysis in chronic uremia is a real prospect capable of improving the patient's clinical and laboratory condition and/or reducing the weekly time of treatment. In line with our previous experience, 5 consenting informed patients on regular dialysis treatment from 9 to 35 months (residual creatinine clearance 0-1.8 ml/min, mean diuresis 350 ml) were treated without interruption for 5-8 months according to a schedule including two combined hemodialysis/hemoperfusion procedures instead of the previous three hemodialysis sessions. Patients were on adequate dialysis and their clinical, metabolic and laboratory conditions were stable. In the hemodialysis/hemoperfusion procedure a cartridge containing 150 g of methacrylate-coated activated charcoal with high biocompatibility was inserted in the dialysis circuit in series with a flat plate or hollow fiber dialyzer. Clinical, laboratory and metabolic conditions remained unchanged in all patients despite the one third reduction in dialysis hours per week. The tolerance of treatment was good: platelets, white cells and fibrinogen were unaffected. The marked reduction in weekly time of treatment led to a more satisfactory personal and social rehabilitation, enabling more patients to be treated with the same facilities.
木炭吸收内源性和外源性毒素的能力已得到充分证实。它能清除比标准透析膜分子量更高的物质。在慢性尿毒症中，将木炭血液灌流作为血液透析的辅助手段定期使用，确实有望改善患者的临床和实验室状况，以及/或者减少每周的治疗时间。根据我们之前的经验，对5名同意并知情的患者进行了治疗，他们接受常规透析治疗9至35个月（残余肌酐清除率0 - 1.8毫升/分钟，平均尿量350毫升），按照一个疗程进行了5至8个月的不间断治疗，该疗程包括两次血液透析/血液灌流联合治疗，取代了之前的三次血液透析。患者接受了充分的透析，其临床、代谢和实验室状况稳定。在血液透析/血液灌流过程中，将一个装有150克具有高生物相容性的甲基丙烯酸酯涂层活性炭的滤筒串联在平板或中空纤维透析器的透析回路中。尽管每周透析时间减少了三分之一，但所有患者的临床、实验室和代谢状况均保持不变。治疗耐受性良好：血小板、白细胞和纤维蛋白原均未受影响。每周治疗时间的显著减少带来了更令人满意的个人和社会康复效果，使更多患者能够在相同的设备条件下接受治疗。
