Solute fluxes in different treatment modalities.
Solute fluxes in different treatment modalities.
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不同处理方式下的溶质通量。
DOI：
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发表时间：
2000
影响因子：
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通讯作者：
J. Leypoldt
中科院分区：
文献类型：
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作者：
J. Leypoldt
在不同的人工肾治疗模式的溶质流量或运输的原则进行审查。计算了血液透析、血液滤过和血液透析滤过期间相同人工肾膜的溶质清除曲线。研究表明，小分子溶质的清除率在很大程度上取决于透析液流速，并且在使用血液透析或血液透析滤过时相似。相反，中分子（尤其是低分子量蛋白）的清除在很大程度上取决于高超滤速率诱导的对流转运，并且在使用血液滤过或血液透析滤过时达到最大化。通过使用后稀释血液透析滤过，可以实现小分子溶质和中分子的最佳通量。最近的研究表明，即使在治疗期间细胞外体积变化正常化后，使用血浆浓度降低也不是β 2-微球蛋白（和其他低分子量蛋白质）清除率的精确测量。建议在未来的研究中报告β 2-微球蛋白清除率，而不是β 2-微球蛋白血浆浓度的标准化降低。有必要进行额外的研究，以确定透析后反弹对β 2-微球蛋白和其他高分子量尿毒症毒素清除率的影响。
The principles governing solute flux or transport in different artificial kidney treatment modalities are reviewed. Solute clearance profiles were calculated for identical artificial kidney membranes during haemodialysis, haemofiltration and haemodiafiltration. It was shown that the clearance of small solutes depends largely on the dialysate flow rate and is similar when using either haemodialysis or haemodiafiltration. In contrast, clearance of middle molecules, especially low-molecular-weight proteins, depends largely on convective transport induced by high ultrafiltration rates and is maximized when using either haemofiltration or haemodiafiltration. Optimal fluxes for both small solutes and middle molecules can be achieved by using postdilution haemodiafiltration. Recent work has shown that use of the reduction in plasma concentration, even after normalization for changes in extracellular volume during therapy, is not an exact measure of beta2-microglobulin (and other low-molecular-weight proteins) clearance. It is proposed that beta2-microglobulin clearance be reported in future studies instead of the normalized reduction in beta2-microglobulin plasma concentration. Additional studies are necessary to determine the effects of postdialysis rebound on the calculated clearance for beta2-microglobulin and other high-molecular-mass uraemic toxins.