中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (05): 353-365.doi: 10.3969/j.issn.1671-4091.2025.05.001

• 指南与共识 •    下一篇

维持性血液透析患者蛋白结合毒素管理中国专家共识(2025版)

维持性血液透析患者蛋白结合毒素管理中国专家共识(2025版)工作组   

  1. 中国医院协会血液净化中心分会
  • 收稿日期:2025-03-18 修回日期:2025-03-21 出版日期:2025-05-12 发布日期:2025-05-12
  • 通讯作者: 韦洮 E-mail:weitao63@163.com

Chinese expert consensus on the management of protein-bound uremic toxins in maintenance hemodialysis patients (2025 edition)

Work group of Chinese expert consensus on the management of protein-bound uremic toxins in maintenance hemodialysis patients (2025 edition)   

  1. Chinese Hospital Association Blood Purification Center Branch
  • Received:2025-03-18 Revised:2025-03-21 Online:2025-05-12 Published:2025-05-12
  • Contact: 100044 北京，北京大学人民医院肾内科 E-mail:weitao63@163.com

摘要： 蛋白结合毒素(protein-bound uremic toxins,PBUTs)是一类相对分子质量较小，但易与血清蛋白结合的尿毒症毒素，其在体内蓄积与维持性血液透析(maintenance hemodialysis,MHD)患者的不良预后密切相关。蛋白结合率较高的PBUTs不易被常规血液透析清除，是目前临床管理的难点。本专家共识在总结现有研究证据的基础上，系统介绍了PBUTs的定义、分类、代谢、对患者的影响及临床管理策略，并结合循证医学证据和临床实践经验，制定了相关推荐意见。本共识旨在提高医务人员对PBUTs的认识，帮助临床医生制定更加合理的诊疗方案以更好地管理MHD患者的PBUTs。

关键词: 蛋白结合毒素, 尿毒症毒素, 维持性血液透析, 血液净化

Abstract: Protein-bound uremic toxins (PBUTs) are small molecular weight uremic toxins that easily bind to serum albumin. The accumulation of PBUTs is associated with poor prognosis in patients with maintenance hemodialysis (MHD). Due to their high protein-binding capacity, PBUTs are difficult to remove by routine hemodialysis, which is currently a challenge in clinical practice. This consensus systematically described the definition, classification, metabolism, hazards, and clinical management strategies of PBUTs. Several recommendations were established based on evidence-based medicine and clinical experience. This consensus aims to help the clinicians to better understand PBUTs and develop rational treatment strategies for the management of PBUTs in MHD patients.

Key words: Protein-bound uremic toxins, Uremic toxins, Maintenance hemodialysis, Blood purification

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