臨牀透析 Vol.19 No.10(5)


特集名 透析量をどう考えるか
題名 透析時間・スケジュールと透析量
発刊年月 2003年 09月
著者 金森 敏幸 産業技術総合研究所バイオニクス研究センターバイオナノマテリアルチーム
【 要旨 】 “透析量”について，尿毒症病因物質の除去量の面から考察した．患者の血中濃度変化が定常状態にあるかぎり，血液透析の治療スケジュール(modality) が異なっても一定期間における治療による除去量は等しく，modalityによって差違が生じるのは，濃度の経時変化だけである．標準的治療と短時間頻回治療において尿毒症病因物質の血中濃度変化がどのように異なるかを，尿酸とBeta2-microglobulin (Beta2-m) を例に，数理モデルを用いて議論した．尿酸およびBeta2-mのTAC (time-averaged concentration) は，1週間の治療時間の総和が同じであっても通常透析に比べて頻回 (連日) 透析のほうが低く，その度合いはBeta2-mでより大きかった．
Theme Imagination and Evaluation of the Dialysis Dose
Title Dialysis dose in relation to hemodialysis treatment modalities
Author Toshiyuki Kanamori Bio-Nanomaterials Team, Research Center of Advanced Bionics, National Institute of Advanced Industrial Science and Technology
[ Summary ] In this paper, "dialysis dose" is discussed in terms of the removal of uremic toxins. The removal of a uremic toxin for a definite period does not differ with the modalities of hemodialysis (HD) treatment and only time-related changes in the concentration of toxins differ with the modalities used. The time-related changes in concentrations of uremic acid (UA) and beta-2-micoroglobulin (Beta2-m) for patients was maintained by standard and short-time daily HD treatments are discussed using a mathematical kinetic model. TAC (time-averaged concentration) of UA and Beta2-m for the short-time daily HD treatment (2hr/treatment and 6 treatments/week) are lower than those for the standard HD treatment (4 hr/treatment and 3 treatments/week). The effect is to produce a decrease in TAC, which is larger for Beta2-m than for UA.
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