| 特集名 | 適正透析 -- エビデンスをめぐる課題 | |
|---|---|---|
| 題名 | 適正血液透析とエビデンス (1) 透析量と透析時間 | |
| 発刊年月 | 2007年 09月 | |
| 著者 | 友 雅司 | 大分大学医学部第二内科 |
| 【 要旨 】 | 透析量と生命予後に関するエビデンスでは，透析量の増加が入院率を減らすことがNCDSより，Kt/Vは生命予後の独立規定因子であることがDOPPSより示された．目本透析医学会の統計調査より，Kt/Vの増加により死亡に対する相対危険度が減少することが示されている．透析時間に関しても，DOPPSより透析時間の短縮が生命予後を悪くするというエビデンスが示され，日本透析医学会の統計調査からも短い透析時間が生命予後を悪くするとの結果が得られ，長時間透析の良好な治療成績も報告されている．透析時間の十分な確保と確保された時間での透析量の達成が重要と考えられる． | |
| Theme | Issues of Evidence-based Adequate Dialysis Therapy | |
|---|---|---|
| Title | Adequate hemodialysis and evidence : Dialysis dose and dialysis time | |
| Author | Tadashi Tomo | Second Department of Internal Medicine, Faculty of Medicine, Oita University |
| [ Summary ] | Concerning the relationship of dialysis dosage to prognosis, it has been shown that an increase in dialysis dosage reduces the risk of morbidity in NCDS patients. It is also known that Kt/V is an additional factor related to mortality as seen in DOPPS. Additionally, an increase in Kt/V is associated with a reduction of risk factors for mortality. The above information was revealed in a statistical report by the JSDT (2002). In relation to dialysis time, the correlation between shortening dialysis time and increases in mortality rates was reported in DOPPS. Furthermore, it was shown that shortened dialysis times elevated the relative risk of death. Conversely, improved outcomes for patients treated with HD for longer periods was reported. To determine the most efficacious dialysis time, determination of optimum dialysis dosages is very important. |
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