居家血液透析的优势与展望

Advantages and prospects of home hemodialysis

居家血液透析(home hemodialysis,HHD)是终末期肾病(end-stage renal disease,ESRD)患者行肾脏替代治疗的方式之一,是在家庭环境中自行或他人辅助下进行的血液透析。早在20世纪60年代,HHD就已经出现并在国外被广泛使用。但由于大量透析中心的建立、腹膜透析的出现以及报销政策的改变等因素,HHD占比一度大幅下降。近年来HHD因为独特的优势再次兴起。HHD不仅能够提高患者生存率,改善患者生存质量,还在新型冠状病毒肺炎疫情的背景下具有重要意义。2020年4月,上海交通大学医学院附属仁济医院开展了中国大陆第一例居家血液透析,弥补了国内HHD的空白。在未来,相信随着互联网的发展、规范的培训体系建立和经验的不断丰富,HHD将拥有广阔的前景。

Home Hemodialysis(HHD)is one of the methods of renal replacement therapy for patients with end-stage renal disease(ESRD),which is performed in a home environment by patients themselves or with the assistance of others.Although HHD has appeared and is widely used abroad as early as the 1960s,the proportion of HHD fell sharply due to the establishment of a large number of dialysis centers,the emergence of peritoneal dialysis,as well as the changes in reimbursement policies.In recent years,HHD has risen again because of its unique advantages.HHD can not only increase the survival rate of patients and improve the quality of life of patients,but also is of great significance in the context of the COVID-19 epidemic.In April2020,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine carried out the first case of home hemodialysis in China's Mainland,filling the gap of HHD in China's Mainland.With the burgeoning development of the Internet,the establishment of a standardized HHD training system and the continuous enrichment of experience,HHD is supposed to have broader prospects.