递增式血液透析的研究进展

Research progress of incremental hemodialysis

摘要:

血液透析治疗是终末期肾脏病的主要治疗手段，其最终目标是改善患者生活质量和生存时间。在医疗资源有限和新型冠状病毒肺炎 (Corona Virus Disease 2019，COVID-19) 疫情下，递增式血液透析作为一种根据患者残余肾功能情况个体化调整透析方案的手段，通过多维度个体化评估患者透析充分性。在不影响住院率和生存率的情况下，递增式血液透析不仅可以更好地保护残余肾功能，还可在一定程度上减轻医疗负担，降低血液透析患者感染新型冠状病毒肺炎的风险。 本文就递增式血液透析的概念、施行条件、提出背景、优势及局限性等方面进行综述，旨在说明递增式血液透析将会是目前医疗及社会环境下符合精准医学要求，并实现医疗安全、生存率、生活质量、医疗费用之间平衡的重要策略，值得进一步关注。

Abstract:

Hemodialysis therapy is the primary treatment for end-stage renal disease with the ultimate goal of improving quality of life and survival time. In the context of limited medical resources and the global prevalence of COVID-19, incremental hemodialysis, as a means of individualizing the dialysis regimen according to the patient's residual renal function, can not only better protect the residual renal function by individualizing the assessment of the patient's dialysis adequacy in multiple dimensions without affecting the hospitalization and survival rate, but also can reduce the medical burden and the risk of COVID-19 infection in hemodialysis patients. This review explains the concept, conditions of implementation, background, advantages and limitations of incremental hemodialysis, and aims to show that incremental hemodialysis will be an important strategy to achieve a balance among medical safety, survival, quality of life, and medical costs in the current medical and social environment in line with the requirements of precision medicine, and deserves further attention.