血液透析时机的选择

Timing of hemodialysis

血液透析是治疗终末期肾脏病主要的肾脏替代治疗方式之一,透析时机是影响患者生存预后的重要因素。目前没有充足的证据支持早透析或晚透析可使患者更受益,关于何时开始透析治疗一直存有争议,各国透析时机临床实践指南缺乏统一标准,不建议单独使用基于血肌酐评估的肾小球滤过率来判断开始透析时机的标准,建议以患者为中心,综合考虑患者的年龄、基础病、并发症、个人意愿、经济状况、家庭照护等因素。急需进一步研发和应用更加客观、准确的评估透析时机的标尺,及时精准地为终末期肾脏病患者制定适宜的透析时机。

Hemodialysis is one of the mainly renal replacement treatments for patients with end-stage renal disease,and the timing of dialysis is an important factor affecting the survival and prognosis of patients.There is no sufficient evidence to support early dialysis or late dialysis which benefit for patients,and it has been controversial that when to start dialysis for patients with end-stage kidney disease,and lack of consistent standards of clinical practice guidelines for timing of dialysis.It is not recommended to determine the timing of dialysis initiation using estimated glomerular filtration rate based on serum creatinine alone,however,it is recommended to take patient-centered including the patient’s age,underlying diseases,complications,personal wishes,economic status,family care,etc.it is necessary to further research and establish more objective and accurate scales to evaluate the timing of dialysis,so as to determine the appropriate timing of dialysis for patients with end-stage renal disease timely and accurately.