ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (4): 386-390.DOI: 10.3969/j.issn.1006-298X.2025.04.017

• 血液净化 • 上一篇    下一篇

延展性血液透析与透析相关性淀粉样变性

  

  • 出版日期:2025-08-28 发布日期:2025-08-28

Expanded hemodialysis and dialysis⁃related amyloidosis

  • Online:2025-08-28 Published:2025-08-28

摘要: 透析相关淀粉样变性 (DRA) 是维持性血液透析 (MHD) 的远期并发症,严重影响患者的生活及透析质量。目前 DRA 仍以预防为主,缺少有效治疗,常用透析模式 (如高通量血液透析及血液透析滤过) 疗效不确定。延展性血液透析 (HDx) 是一种使用中截留量膜的新型血液透析模式,经济成本低于血液透析滤过,可以更好地清除 β₂微球蛋白 (β₂-MG) 等中大分子毒素,改善患者的微炎症状态,为预防提供理论依据。本文拟就 DRA 的发病机制,以及 HDx 治疗 DRA 的理论依据和优势进行综述。

关键词: font-family:Inter, -apple-system, BlinkMacSystemFont, ", font-size:16px, background-color:#F9FAFB, ">延展性血液透析, 中截留量血液透析, 维持性血液透析, 透析相关性淀粉样变性

Abstract: Dialysis⁃related amyloidosis is a long⁃term complication of maintenance hemodialysis, which seriously affects the quality of life and dialysis of MHD patients. The treatment should focus on prevention, and there is a lack of effective treatment. Common dialysis methods such as high⁃flux hemodialysis and hemodiafiltration have uncertain therapeutic effects. Expanded hemodialysis (HDx) is a novel hemodialysis mode that uses medium cut⁃off membranes. Its economic cost is lower than that of hemodiafiltration. It can better remove medium and large molecular toxins such as β₂-MG and improve the microinflammatory state of MHD patients, providing a theoretical basis for the prevention of DRA. This article reviews the pathogenesis of dialysis⁃related amyloidosis, and the theoretical basis and advantages of HDx in treating DRA.

Key words: font-family:Inter, -apple-system, BlinkMacSystemFont, ", font-size:16px, background-color:#F9FAFB, ">expanded hemodialysis, medium cut?off hemodialysis, maintenance hemodialysis, dialysis?related amyloidosis