特集名 | 透析医工学の最前線 | |
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題名 | 透析医療技術の進歩 (2) I-HDFの有効性と適応 | |
発刊年月 | 2019年 05月 | |
著者 | 亀井 大悟 | 東京女子医科大学臨床工学科 |
著者 | 峰島 三千男 | 東京女子医科大学臨床工学科 |
著者 | 土谷 健 | 東京女子医科大学血液浄化療法科 |
【 要旨 】 | 間歇補充型血液透析濾過(I-HDF)は,限られた透析時間内で間欠的,定時的に少量の補充液の注入と回収が施行されるオンラインHDFの一法である.透析低血圧症の予防や末梢循環障害の是正,plasma refillingの促進などに有効である.低栄養や高齢者,透析中血圧低下・透析困難症の患者,透析間体重増加が多い患者,末梢循環不全を合併する患者に効果的な適応と考えられる. |
Theme | Current topics in medical engineering technologies for dialysis therapy | |
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Title | Clinical adaptation and efficacy of intermittent infusion hemodiafiltration | |
Author | Daigo Kamei | Department of Clinical Engineering, Tokyo Women's Medical University |
Author | Michio Mineshima | Department of Clinical Engineering, Tokyo Women's Medical University |
Author | Ken Tsuchiya | Department of Blood Purification, Tokyo Women's Medical University |
[ Summary ] | Intermittent infusion hemodiafiltration (I-HDF) is a technique used to intermittently infuse ultra-pure dialysates into a patient's blood via a dialysis membrane. I-HDF was developed as a form of online HDF therapy. Several types of dialysis machines (including those employing an I-HDF mode) are commercially available. Presently, I-HDF can be safely and conveniently performed using these machines. I-HDF prevents membrane fouling, improves peripheral circulation, enhances plasma refilling, minimizes the decline in membrane performance that occurs over time, ensures enhanced solute removal, stabilizes blood pressure, reduces the number of required treatments involving medical professionals, particularly in elderly and malnourished patients, in patients with relatively large fluctuations in blood pressure readings, as well as in those with peripheral arterial disease. It is expected that clinical studies performed in the near future will provide a better understanding of the clinical adaptation of I-HDF. |