N-乙酰半胱氨酸对接受高通量合成透析膜治疗的慢性血液透析患者残余肾功能的影响:一项试点研究。

ISRN nephrology Pub Date : 2012-11-26 eCollection Date: 2013-01-01 DOI:10.5402/2013/636208
Leonid Feldman, Ramzia Abu Hamad, Shai Efrati, Ali Ashker, Ilia Beberashvili, Michal Shani
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摘要

背景。事实证明,保持慢性透析患者的残余肾功能是预测其存活率的一个重要指标。本研究旨在探讨联合使用 N-乙酰半胱氨酸和高通量生物相容性血液透析膜能否改善血液透析患者的残余肾功能。患者和方法。对残余尿量至少为 100 毫升/24 小时的慢性血液透析患者口服 N-乙酰半胱氨酸 1200 毫克,每天两次,连续两周。治疗组包括使用高通量合成生物兼容膜透析器的患者。对照组包括使用低通量三醋酸半合成血液透析膜的透析器治疗的患者。研究结果18 名患者参加了研究。两组患者的残余肾小球滤过率均呈非显著上升趋势。使用 N-乙酰半胱氨酸后,高通量生物相容性膜组的肾小球滤过率改善幅度较小:治疗组为 +0.17 ± 0.56 mL/min/1.73 m(2),对照组为 +0.65 ± 0.53 mL/min/1.73 m(2)(P < 0.05)。结论在这项研究中,N-乙酰半胱氨酸对慢性血液透析患者残余肾功能的有利影响在使用高通量生物相容性高清膜而非低通量半合成高清膜时可能不那么明显。
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Effect of N-acetylcysteine on residual renal function in chronic haemodialysis patients treated with high-flux synthetic dialysis membranes: a pilot study.

Background. Preservation of residual renal function in chronic dialysis patients has proven to be a major predictor of survival. The aim of the present study was to investigate an ability of the combined use of N-acetylcysteine and high-flux biocompatible haemodialysis membranes to improve residual renal function in haemodialysis patients. Patients and Methods. Chronic haemodialysis patients with a residual urine output of at least 100 mL/24 h were administered oral an N-acetylcysteine 1200 mg twice daily for 2 weeks. Treatment group included patients treated with dialysers using high-flux synthetic biocompatible membranes. Control group included patients treated with dialysers using low-flux semisyntetic triacetate haemodialysis membranes. Results. Eighteen patients participated in the study. The residual glomerular filtration rate showed a nonsignificant trend for increase in both groups. The magnitude of GFR improvement after N-acetylcysteine administration was less pronounced in the group treated with high-flux biocompatible membranes: +0.17 ± 0.56 mL/min/1.73 m(2) in treatment group and +0.65 ± 0.53 mL/min/1.73 m(2) in control group (P < 0.05). Conclusion. In this study of favorable effect of N-acetylcysteine on residual renal function in chronic haemodialysis patients may be less pronounced when using high-flux biocompatible, rather than low-flux semisyntetic, HD membranes.

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