Incremental Hemodialysis: How I Do It
Incremental Hemodialysis: How I Do It
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DOI：
10.1111/sdi.12530
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发表时间：
2016-11-01
影响因子：
1.6
通讯作者：
Golper, Thomas A.
中科院分区：
文献类型：
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作者：
Golper, Thomas A.
渐进式血液透析（incrHD）没有被广泛使用，也没有被很好地理解。此外，或许影响更大的是，美国的政府法规及其对透析提供者组织的后续影响使得incrHD的实践比传统的每周三次的中心HD更加困难。IncrHD严重依赖于残余肾功能（RKF）的数量以及终末期肾病（ESRD）管理的个体化目标。必须经常评估RKF，并相应地调整透析。家庭高清比中央高清更适合增量方式。这可能是由于提供者的经验更丰富，患者和家属对治疗的了解更多，有利于增加hd的透析平台的可用性，和/或其较少繁重的政府监管。我长期以来都有进行渐进式透析（腹膜透析和血液透析）的成功经验，在此分享我治疗incrHD的实践策略和方法。
Incremental hemodialysis (incrHD) is not widely used nor is it well understood. In addition, and perhaps with more impact, governmental regulations in the United States and their consequential influences on dialysis provider organizations have made the practice of incrHD more difficult than traditional thrice weekly in-center HD. IncrHD is critically dependent on the amount of residual kidney function (RKF) as well as the individualized goals of end-stage renal disease (ESRD) management. RKF has to be assessed frequently and dialysis adjusted accordingly. Home HD lends itself to an incremental approach more so than in-center HD. This may be due to more experience of the provider, more knowledge of the therapy by the patient and family, the availability of dialysis platforms conducive to incrHD, and/or that its less onerous regulation by the government. I have had a long and successful experience performing incremental dialysis (both peritoneal and hemodialysis) and share here my practice strategies and approaches for incrHD.