The Korean Journal of Medicine

  • 제86권2호
  • /
  • Pages.131-137
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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혈액투석

Hemodialysis

  • 이영기 (한림대학교 의과대학 내과학교실, 한림대학교 신장연구소) ;
  • 오지은 (한림대학교 의과대학 내과학교실, 한림대학교 신장연구소)
  • Lee, Young-Ki (Department of Internal Medicine, Hallym University College of Medicine, Hallym Kidney Research Institute) ;
  • Oh, Jieun (Department of Internal Medicine, Hallym University College of Medicine, Hallym Kidney Research Institute)
  • 발행 : 2014.02.01
⟨ 이전 논문 다음 논문 ⟩

초록

With the widespread availability of dialysis, the lives of end-stage renal disease patients have been prolonged over the past fifty years. Hemodialysis relies on the diffusion of molecules across a semipermeable membrane along the concentration gradient. In addition to diffusion, movement of waste products from the circulation into the dialysate can occur as a result of convective clearance. Use of high-flux dialyzer has increased the removal of the middle molecules such as ${\beta}_2$-microglobulin. Recently on-line hemodiafiltration which combined the hemodialysis and hemofiltration to increase the convective clearance of the large molecules has been available. About the hemodialysis adequacy, the result of hemodialysis (HEMO) study suggests that increasing the dose to greater than a single-pool $Kt/V_{urea}$ 1.4 does not improve the survival of the patients. While the technical and scientific improvement in hemodialysis has led to a noticeable improvement in the survival of the dialysis patients, cardiovascular mortality and event rates are extraordinarily high in dialysis population. In addition to hemodialysis treatment, nephrologists taking care of dialysis patients must recognize and treat the diverse complications that can result from the loss of kidney function.

키워드

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