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首页> 外文期刊>Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy >Post-Dilution HemodiafiltrationWith a Heparin-Grafted Polyacrylonitrile Membrane
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Post-Dilution HemodiafiltrationWith a Heparin-Grafted Polyacrylonitrile Membrane

机译：肝素接枝聚丙烯腈膜稀释后血液透析滤过

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The aim of this multicenter, prospective study was to explore the possibility of carrying out routine sessions of post-dilution hemodiafiltration with a polyacrylonitrile membrane grafted with heparin (HeprAN) and reduced anticoagulation. Forty-four patients from eight centers were included in the study and treated by means of post-dilution on-line hemodiafiltration with automatic control of TMP, according to three different modalities tested consecutively: phase 1, polyethersulfone filter primed with heparinized saline and anticoagulated with continuous infusion of unfractionated heparin 1000/h; phase 2, HeprAN membrane filter primed with saline without heparin. Anticoagulation: a 1000-unit bolus of unfractionated heparin at the start of session followed by a second one at the end of the second dialysis hour; phase 3, same filter and priming procedure as in phase 2; anticoagulation with nadroparin calcium at the beginning of treatment. Partial or massive clotting of the dialyzer occurred in less than 1% of sessions in phase 1; 10% and 7% in phase 2; and 1% and 2% in phase 3. Clotting limited to the drip chambers was observed in 13%, 34% and 12%, respectively. The study of coagulation parameters showed a better profile when low-molecular weight heparin (LMWH) was used in association with HeprAN membrane, while the generation of TAT complexes did not differ from that observed with the standard anticoagulation modality used in phase 1. Our results suggest that the HeprAN membrane can be used safely in routine post-dilution hemodiafiltration with reduced doses of LMWH.
机译：这项多中心，前瞻性研究的目的是探讨使用肝素（HeprAN）移植的聚丙烯腈膜进行稀释后血液透析滤过的常规操作以及减少抗凝的可能性。来自8个中心的44名患者被纳入研究，并根据连续测试的三种不同方式，通过自动控制TMP的稀释后在线血液透析滤过进行治疗：第1阶段：肝素化盐水灌注的聚醚砜滤池，并用抗凝剂连续输注普通肝素1000 / h;第2阶段，用不含肝素的盐水灌注的HeprAN膜过滤器。抗凝：在疗程开始时以1000单位的普通肝素推注，然后在第二个透析小时结束时再注射一次。第三阶段，与第二阶段相同的过滤器和启动程序;在治疗开始时用萘达普林钙进行抗凝治疗。在第一阶段，透析器的部分或大量凝结发生在少于1％的阶段中。第二阶段分别为10％和7％;在阶段3中分别为1％和2％。观察到分别限于滴注室的凝结分别为13％，34％和12％。当将低分子量肝素（LMWH）与HeprAN膜结合使用时，凝血参数的研究显示出更好的曲线，而TAT复合物的生成与第一阶段中使用的标准抗凝方式所观察到的没有差异。提示HeprAN膜可安全地用于常规的稀释后血液透析滤过，并减少LMWH剂量。

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