特集名 | 透析アミロイドーシス -- ブレイクスルーを前に | |
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題名 | 血液浄化による透析アミロイドーシスの予防 | |
発刊年月 | 2009年 01月 | |
著者 | 友 雅司 | 大分大学医学部総合内科学第二講座 |
【 要旨 】 | 長期透析患者の合併症としての透析アミロイドーシスの発症・進展予防には,血液浄化による尿毒素の効果的な除去と,血液浄化の生体適合性を高めることが重要である.high flux透析膜の使用やHDF (hemodiailtration) 療法は透析アミロイドーシスの対策として有用であり,透析液の清浄化もbeta2-ミクログロブリン (beta2-m) の産生抑制と微細炎症反応の抑制をもたらす.また,酢酸フリー透析液の使用も,血液浄化の生体適合性を高める可能性が示唆されており,透析アミロイドーシスの進展予防に有用かもしれない.これら血液浄化の除去性能と生体適合性を可能なかぎり高めることが透析アミロイドーシスの発症・進展予防に重要である. |
Theme | Dialysis related amyloidosis -- The breakthrough is close at hand | |
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Title | Blood purification for prevention of dialysis related amyloidosis | |
Author | Tadashi Tomo | Second Department of Internal Medicine, Oita University Faculty of Medicine |
[ Summary ] | To prevent the manifestation or progression of dialysis related amyloidosis (DRA) as complications of long term dialysis therapy, it is important to raise the removal ability of uremic toxins and the biocompatibility of blood purification techniques. Hemodialysis therapy using of high flux membrane filters or hemodiafiltration therapy are both useful to treat dialysis related amyloidosis. Purification of the dialysate may also restrain the generation of beta2-microglobulin or micro inflammation. It has been revealed that dialysis therapy, using acetate free dialysis fluids, may make it possible to raise the biocompatibility of blood purification methods. In this sense, dialysis therapy, using acetate free dialysis fluids, may be useful to provide preventative therapy, to slow or stop the progression of dialysis related amyloidosis. To raise the removal ability and biocompatibility levels of blood purification techniques as much as possible it is important to prevent the manifestation or progression of dialysis related amyloidosis. |