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中华肾病研究电子杂志 ›› 2015, Vol. 04 ›› Issue (03) : 132 -136. doi: 10.3877/cma.j.issn.2095-3216.2015.03.005

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血液透析患者的干体重管理
吴广礼1,(), 陈云爽1   
  1. 1. 050082 石家庄,白求恩国际和平医院肾脏病科
  • 出版日期:2015-06-28
  • 通信作者: 吴广礼

Dry weight management for patients with hemodialysis

Guangli Wu1,(), Yunshuang Chen1   

  1. 1. Department of Nephrology, Bethune International Peace Hospital, Shijiazhuang, Hebei Province 050082, China
  • Published:2015-06-28
  • Corresponding author: Guangli Wu
  • About author:
    Corresponding author: Wu Guangli, Email:
引用本文:

吴广礼, 陈云爽. 血液透析患者的干体重管理[J/OL]. 中华肾病研究电子杂志, 2015, 04(03): 132-136.

Guangli Wu, Yunshuang Chen. Dry weight management for patients with hemodialysis[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2015, 04(03): 132-136.

干体重是评价血液透析充分性的重要指标,对于提高血液透析患者的生存率和生活质量至关重要。随着医学实践的进步,干体重的定义不断发展,概念逐步演变。干体重设定过高可影响血压、心血管系统稳定性和炎症因子,但干体重设定过低可增加血管通路阻塞的风险,造成残余肾功能丧失的风险增加以及增加血液透析间期低血压相关的并发症。目前临床上干体重评估方法有临床评估法、下腔静脉直径测定法、同位素测定法、血浆标志物测定法、无创血容量监测及生物电阻抗频谱分析法等,每种方法均存在其局限性。干体重不达标主要是因为患者不遵从医嘱、血液透析时间短、钠摄入过多等。临床上应分析患者具体情况采取针对性措施以达到目标干体重。

Dry-weight is an important assessment index for adequacy of hemodialysis, and is vital for improving the survival rate as well as quality of life of patients. With the advances in medical practice, the dry weight definition has developed gradually and the concept evolved. Too high dry weight can affect blood pressure, cardiovascular system stability, and inflammatory factors, while too low dry weight may increase the risk of vascular access obstruction and loss of residual renal function, and increase hypotension-related complications during hemodialysis. Currently clinical methods for evaluation on dry weight includes clinical evaluation, determination for diameter of the inferior vena cava, isotope determination, determination of plasma markers, non-invasive blood volume monitor, and bio-electrical impedance spectra analysis, and so on, but each method has its limitations. Clinically dry weight dissatisfaction is mainly because of patients′ failing to follow the doctor′s advice, short time of hemodialysis, and excess sodium intake, etc. Clinical analysis of patients′ specific conditions should be performed to take targeted measures for achieving the goal of dry weight.

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