| 特集名 | オンラインHDF―展開と課題 | |
|---|---|---|
| 題名 | 本邦のオンラインHDFの実際（5）間歇補充型HDF（I-HDF）の有効性 | |
| 発刊年月 | 2017年 05月 | |
| 著者 | 江口 圭 | 東京女子医科大学臨床工学部 |
| 著者 | 峰島 三千男 | 東京女子医科大学臨床工学部臨床工学科 |
| 【 要旨 】 | 近年，透析膜を介して間歇的に少量の液補充を行う間歇補充型HDF (I-HDF)がオンラインHDFの一法として施行されている．現在，I-HDF専用モードを搭載した多くの透析装置が販売されるようになり，安全かつ簡便に施行可能となった．I-HDFは，とくに低栄養，高齢者，血圧変動幅が大きい患者，末梢動脈疾患（PAD）合併症例などを対象に施行され，その有効性として，①末梢循環改善，②plasma refilling促進，③膜性能の経時減少抑制，④溶質除去の促進，⑤血圧の安定化，⑥処置回数の減少などが報告されている．今後，I-HDF研究会などを中心に長期的な臨床データの蓄積が進み，その有効性がさらに明らかにされればI-HDFはさらに発展するものと思われる． | |
| Theme | Online hemodiafiltration (HDF) -- expansion and issues | |
|---|---|---|
| Title | Clinical efficacy of intermittent infusion hemodiafiltration (I-HDF) | |
| Author | Kei Eguchi | Department of Clinical Engineering, Tokyo Women's Medical University |
| Author | Michio Mineshima | Department of Clinical Engineering, Tokyo Women's Medical University |
| [ Summary ] | Recently, intermittent infusion hemodiafiltration (I-HDF), in which ultra-pure dialysates are intermittently infused into patients' blood via a dialysis membrane, has been developed as one form of online HDF therapy. Presently, many types of dialysis machines including those employing an I-HDF mode are commercially available. As a result, it has become possible to perform I-HDF treatments using these machines safely and conveniently. As has already been reported, I-HDF is effective in improving peripheral circulation, enhanced plasma refilling, suppression of decreases in membrane performance over time, enhanced solute removal, stabilization of blood pressure, reduction of number of treatments by medical staffs, especially for patients with malnutrition, elderly patients, patients with relatively large blood pressure fluctuation and patients with peripheral arterial disease (PAD). It is expected that the clinical effectiveness of I-HDF will be clarified based on several clinical studies and I-HDF will be further developed in the near future. |
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