Clinical Benefit of an Adsorptive Technique for Elderly Long-Term Hemodialysis Patients.

4区医学 Q3 Medicine

Contributions to nephrology Pub Date : 2019-01-01 Epub Date: 2019-04-16 DOI:10.1159/000496527

Takahiro Kuragano, Arithoshi Kida, Mana Yahiro, Takeshi Nakanishi

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引用次数: 3

Abstract

Background: With the advancement of technology, a dialysis membrane has been developed to achieve the efficient removal of beta-2 microglobulin (β2MG), which could not be removed with previous hemodialysis (HD) membranes. Recently, there has been an increase in the population of elderly chronic kidney disease (CKD) patients with chronic inflammation and malnutrition. The optimal extracorporeal circulation treatment for elderly CKD patients is not certain.

Summary: We have reported the clinical advantages, such as improvements in nutritional, inflammatory, and hemodynamic conditions, of the adsorptive HD membrane for elderly HD patients. We have also reported that the use of β2MG adsorption columns improved the symptoms of dialysis-related amyloidosis and the number of bone cysts, which could not be improved by the high-flux hemodialyzer. Both the adsorptive HD membrane and β2MG adsorption columns remove uremic toxins and inflammatory cytokines via adsorption without aggravating the nutritional condition of these patients. Key Messages: We should reconsider the mechanisms of adsorption, in addition to diffusion and convection, in the extracorporeal circulation treatment of elderly HD patients.

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吸附技术在老年长期血液透析患者中的临床应用。

背景:随着技术的进步，人们开发了一种透析膜，可以有效去除β -2微球蛋白(β2MG)，而以前的血液透析膜无法去除β -2微球蛋白(β2MG)。近年来，伴有慢性炎症和营养不良的老年慢性肾脏疾病(CKD)患者数量有所增加。老年CKD患者体外循环治疗的最佳方案尚不确定。摘要:我们报道了吸附性HD膜治疗老年HD患者的临床优势，如营养、炎症和血流动力学状况的改善。我们也报道了β2MG吸附柱的使用改善了透析相关淀粉样变的症状和骨囊肿的数量，这是高通量血液透析器无法改善的。HD吸附膜和β2MG吸附柱均通过吸附去除尿毒症毒素和炎性细胞因子，而不会加重患者的营养状况。关键信息:在老年HD患者体外循环治疗中，除了扩散和对流外，我们还应该重新考虑吸附机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contributions to nephrology 医学-泌尿学与肾脏学

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The speed of developments in nephrology has been fueled by the promise that new findings may improve the care of patients suffering from renal disease. Participating in these rapid advances, this series has released an exceptional number of volumes that explore problems of immediate importance for clinical nephrology. Focus ranges from discussion of innovative treatment strategies to critical evaluations of investigative methodology. The value of regularly consolidating the newest findings and theories is enhanced through the inclusion of extensive bibliographies which make each volume a reference work deserving careful study.