【摘要】目的 探讨高容量血液透析滤过(HDF)对终末期肾病(ESRD)的临床疗效、尿毒素清除率及患者对治疗的耐受性。方法 32例维持性血液透析并伴有血液透析并发症或难以耐受常规血液透析的患者随机分为2组。高容量HDF组：患者13例接受高容量置换液(20L)后稀释HDF治疗。高通量HD组：患者19例接受高通量血液透析(HD)治疗。对2组患者治疗前后血肌酐(SCr)、尿素氮(BUN)、血磷(SP)、β2 微球蛋白(β2-MG)、及临床耐受性进行对比分析。结果 高容量HDF对小分子及中分子毒性物质的清除显著优于高通量HD，患者对治疗的耐受显著提高，临床症状缓解明显。 结论 高容量HDF较高通量HD能明显提高清除患者血中大、中、小分子毒性物质。血液透析并发症明显减少或消失。血液透析耐受性提高，是血液透析并发症患者和血液透析耐受性低的患者较好的治疗选择。

【Abstralt】Objective To evaluate the effect of high volume hemodiafiltration (HDF) and tolerance of patients to the treament.Methods 32 of maintenance hemodialysis patients who associated with hypertension, hypotension, arrhythmia, angina pectoris, uremicpr uritus and severe calcium-phosphate metabolic disorder during HD were randomly divided into two groups. The patients received high volume post-dlilution HDF(substitute fluid 20L) and high-flux hemodialysis respectively. F60 dialysers were employed for all groups.Results The group of high volume HDF showed better tolerance than the group of HD, the dialysis complications were much less in high volume HDF patients than that of HD (P<0.01). The clearances fo β2-MG, BUN, Scr and SP were higher than that of HD. Conclusion High volume HDF is an effective method for removing low and middle molecular uremic toxins. It improves patient's tolorance to dialysis treatment and decreases the episode of hypertension, hypotension, arrhythmia and angina.