中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (04): 241-244,289.doi: 10.3969/j.issn.1671-4091.2024.04.001

• 专家述评 •    下一篇

高容量HDF的获益证据与实现

杜 卉   左 力   

  1. 100028 北京，1费森尤斯医疗全球医疗办公室
    100044 北京，2北京大学人民医院肾内科
  • 收稿日期:2023-12-28 修回日期:2024-01-19 出版日期:2024-04-12 发布日期:2024-04-12
  • 通讯作者: 左力 E-mail:zuoli@bjmu.edu.cn

Evidence of benefits and achievement of high-volume hemodiafiltration

DU Hui, ZUO Li   

  1. Global Medical Office, Fresenius Medical Care, Beijing 100028, China; 2Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2023-12-28 Revised:2024-01-19 Online:2024-04-12 Published:2024-04-12
  • Contact: 100044 北京，2北京大学人民医院肾内科 E-mail:zuoli@bjmu.edu.cn

摘要： 血液透析滤过(hemodiafiltration,HDF)结合了弥散与对流的溶质清除方式，以更好地清除较大分子量的尿毒症毒素。该治疗模式是否可以为需要肾脏替代治疗的终末期肾病(end-stage renal disease,ESRD)患者带来长期生存获益一直存有争议，近期高剂量HDF与高通量血液透析的比较(comparison of high-dose hemodiafiltration with high-flux hemodialysis，CONVINCE)研究结果的发表或将成为该争议终结的里程碑。本综述系统梳理了HDF临床获益的证据以及高容量HDF实现的重要影响因素和阶梯式实现方案。

关键词: 血液透析滤过, 肾脏替代治疗, 终末期肾病

Abstract: Hemodiafiltration(HDF)works by combining diffusive and convective solute removal to provide a greater removal of larger molecular weight uremic toxins. The recent publication of the CONVINCE study might be a milestone in ending the controversy over whether this treatment modality can provide long-term survival benefits for patients with end-stage renal disease(ESRD)requiring renal replacement therapy. This review gives a brief overview of the current evidence for the clinical benefits of HDF as well as the important factors and stepwise protocols for high-volume HDF achievements.

Key words: Hemodiafiltration, Renal replacement therapy, End-stage renal disease

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