臨牀透析 Vol.23 No.5(10)


特集名 透析液清浄化技術の最前線
題名 透析液清浄化と臨床症状との関係
発刊年月 2007年 05月
著者 政金 生人 矢吹病院
【 要旨 】 透析液清浄化の臨床効果は透析アミロイド症の遅延,MIA症候群の予防,エリスロポエチン不応性の改善,残存腎機能の維持など多数報告されている.これらのすべては尿毒症物質の蓄積と生体適合性不良からなる微細炎症の惹起という共通の基盤の上にある.透析液清浄化の臨床効果にはエビデンスレベルの高い研究は少ないが,実際に経験してみると非常に強いインパクトがある.長期透析患者が世界に類をみないほど多いわが国では,透析液水質に関しては世界でもっとも厳格な規範をもつべきである.
Theme The Front of Dialysate Purification Technologies in Hemodialysis Therapy
Title Clinical impacts of ultrapure dialysis fluids on CKD patients
Author Ikuto Masakane Yabuki Hospital
[ Summary ] There have been many reports on the clinical impact of ultrapure dialysis fluids in the retardation of dialysis related amyloidosis and MIA syndrome, for the preservation of residual renal functions and improvements in renal anemia. The common mechanism of these effects is based on the interaction between the retention of uremic toxins and the bio-incompatibility of dialysis therapy alone. There are few reports with high evidence level in these papers. However, our experiences with the purification of dialysis fluids has had a strong impact on our institution and have become a great motivation to keep dialysis fluids clean. Because we have to treat many CKD patients with RRT for long periods in Japan, we must have highly stringent guidelines for dialysis fluid quality.
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