On-line血液透析滤过对移植肾功能延迟恢复的影响

The effect of on-line hemodiafiltration in the treatment of delayed graft function

目的 研究On -line血液透析滤过 (HDF)在移植肾功能延迟恢复患者中的应用。方法 我院2 0 0 2年 1月至 2 0 0 3年 7月肾移植术后发生移植肾功能延迟恢复患者 38例 ,2 9例采用Freseniuson -lineHDF透析机 ,F6 0透析器 ,透析滤过时间 3～ 4h ,血流量在 180～ 2 5 0ml/min ,置换液采取前稀释法 ,9例行HD治疗 ,采用GambroAK2 0 0透析机 ,F7透析器。结果 38例移植肾功能延迟恢复患者 ,2 9例用联机血液透析滤过 ,平均肾功能恢复时间为 ( 11.2± 5 .6 )天 ,治疗期间收缩压变化在 110～ 170mmHg,透析期间低血压发生率为 2 .6 % ,9例HD治疗者平均肾功能恢复时间为 ( 2 2 .3± 15 .7)天 ,透析期间低血压发生率为 13.2 %。结论 与HD比较 ,On -lineHDF对血压影响较小 ,可缩短移植肾功能恢复的时间。

Objective To investigate the effect of on-line hemodiafiltration in the treatment of delayed graft function. Methods One hundred and fourteen times of on-line hemodiafiltration treament were performed on 29 patients and 68 times hemodialysis were performed on 9 patients. Results Twenty-nine patients undergoing hemodiafiltration had shorter period for graft function recovery than that of the 9 patients undergoing hemodialysis.(11.2±5.6d vs 22.3±15.7d, P<0.05).Hypotension occurred in 13.2% patients receiving hemodialysis while 2.6% patients receiving hemodiafiltration(P<0.05). Conclusion Compared with hemodialysis, on-line hemodiafiltration has less influence on blood pressure than hemodialysis and may shorten graft function recovery time.