Sanz-Moreno C, Botella J
Nephrology Departement, Puerta de Hierro University Hospital, Madrid, Spain.
Artif Organs. 1995 May;19(5):407-10. doi: 10.1111/j.1525-1594.1995.tb02350.x.
Paired filtration dialysis (PFD) is the only hemodiafiltration (HDF) technique in which ultrafiltrate (Uf) is obtained continuously with a similar composition to plasma. It has been proved that Uf is regenerated when it passes through an uncoated adsorbent charcoal cartridge: this one removes medium-to-large solutes and small toxines (except for urea and phosphates), but not the electrolytes and bicarbonate. This regenerated Uf can be used like replacement fluid, using the same Uf pump as the infusion pump; this makes the HDF technique easier and more reliable. During 12 months (3 h/3 sessions/week), we treated 13 patients with this PFD-Charcoal technique. These patients were previously on conventional PFD for at least 6 months. The biochemical results were excellent with a stabilization of all parameters (urea, creatinine, uric acid, Na, K, Cl, Ca, phosphates, beta 2-microglobulin, beta 2M, etc.) and a better control of acidosis (statistically significative after 6 months). The clinical tolerance was also excellent, and the technique was greatly simplified. We conclude that PFD-Charcoal is a good HDF technique that avoids the use of exogenous replacement fluid by using the regenerated Uf itself as an endogenous substitution fluid with bicarbonate.
配对过滤透析（PFD）是唯一一种能持续获得与血浆成分相似的超滤液（Uf）的血液透析滤过（HDF）技术。已证实，超滤液通过未涂层的吸附性炭罐时会再生：该炭罐可清除中到大分子溶质和小毒素（尿素和磷酸盐除外），但不会清除电解质和碳酸氢盐。这种再生的超滤液可用作置换液，使用与输液泵相同的超滤液泵；这使得血液透析滤过技术更简便、更可靠。在12个月（每周3次，每次3小时）的时间里，我们用这种PFD-炭技术治疗了13名患者。这些患者此前接受传统PFD治疗至少6个月。生化结果非常好，所有参数（尿素、肌酐、尿酸、钠、钾、氯、钙、磷酸盐、β2-微球蛋白等）均稳定，酸中毒得到更好控制（6个月后具有统计学意义）。临床耐受性也很好，且该技术大大简化。我们得出结论，PFD-炭是一种很好的血液透析滤过技术，通过将再生的超滤液本身用作含碳酸氢盐的内源性替代液，避免了使用外源性置换液。
