Αιμοκάθαρση

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 24

15 11528

.: 2107298586
FAX: 2107237705
E-mail: nefreter@otenet.gr

HELLENIC SOCIETY OF NEPHROLOGY


15 MEANDROU STR. ATHENS, 11528
GREECE

TEL.: (+3021) 07298586


FAX: (+3021) 07237705
E-mail: nefreter@otenet.gr

(. 2)

(. 4)
(. 7)
(. 11)

(. 14)

(. 16)
(. 20)
(. 23)

/
1)
)

3 12
/,





.

.
) / (High-flux)

()
.
:
1)
2)
3)
4)

(
)
on-line * .


.
* ON-LINE
1.
2.
3.
4.
5.
6.
7.
8.

: Contribution nephrol 2007; 158 : 225-231


On line hemodiafiltration (technical options and
best clinical practices) B.Cannaout. In Roncocy,
Cannaout B, Aljama P (eds) : Hemodiafiltration,
Karger 2007, pp110-123


(

, ,
).


() ,
( 2 )
.

3
/,
(Equilibrated Kt/V).
3 /,
() Kt/V (std Kt/V),
(SRI) (EKR).

IV)

3 /
eKt/V 1.2.
, eKt/V 1.4,
-.


3 /,
SRI=2.

2)


:

I)

.

.
.

.
20mmHg
10mmHg
/.


.

)

6gr/, (..
),
2 ,
. ,

, .


. ,

.

() (Ultrafiltration profiling)
.
(
)

.

(Sodium profiling),
( 144mmol/l),
,

.
.

1,5mmol/l
, .


0,25mmol/l,
.

35-36C ( )

.
0,5C 36,5C .
35C .


,
.



,
.

,
.

(Minontrine- 1 ) 2,5-10mg 30
,
.

L-
.

V)

1 : ( ),
,
, , 36,5C,

2 :
, ,
36,5C ( 35C)
( : ), ,
,
1,5mmol/l

3 ( ) : , L-
( ).

V)

trendelenburg (
,
).

.

4 trendelenburg
.

.

3)
) :


.

.
, 6
50 .
5 ,
3.

)

:
-

, (BM),
(SGA), , (nPNA),
, (, DEXA, NEAR-INFRAND REACTANCE).

:
) :
.
.

.

,
.
) (BMI) : BMI
> 23
) (Subjective Global Assessement, SGA) : SGA

) :
.
4
fistoula.
) (nPNA):
1g/kg /
) - :
40g/l, .

. -
0,3g/l.
) :
.
) ( ) :
.

)

:
) :
6-12 3 50
5 .
24
.
) :
5% . ,
2
.
) nPA, : nPA,
1 3
.
(
, , )
.

V)
)
1,1g /kg /. nPA
1g/kg /.
)
30-40 /kg /, ,
.

(1)
(2)
(6)
(c)
(9)
(12)
(3)
(8)
(5)
()
- ()

1,1-1,2mg*
1,1-1,3 mg
10mg
75-90mg
1mg
2,4g
14-16mg
30g
5mg
700-900g ()
400-800IU
90-120g ()
800-1000mg ()
2000mg
(,
)

2000-2300mg (, .. 5-6g )

50-70mmol ()

8mg () 15mg ()
( EPO)

10-15mg () 8-12mg ()
(
)

55g (
)
* ( )
(per os IV).

V)


.
3 .

.


.

.




.
( ) ,
.

10


> 20 /kg /, 0,8gr/kg ,
.


3-6 .
15.
(, , ,
,
).
.

,
6-12 (
).

20-22mmol/L.
<20mmol/L

(
40mmol/L) .

4)


.
,
.

,
.


4 (GFR<30ml/min/1,73m2)

.



.

.


(
>600cc/min > 5ml, ).
()

.

.

.

V)

11

/
.
.

( ) ,
.

(
: >4 ).
(rope ladder technique)
.

V)




( triplex
transoning, crit-line III,).

VI)


,
().


.

, .

VII)

,
.

.


.

VIII)

IX)

12



.
,
.
.



.

.

( , ),
.

.
( )
.

.
,
.

13


2

2 .


2 4
.

,
.
.

.

.

5)

)


, ,

,
,
(unfractionated heparine).
,

,
(

)

.

V)
)


( HI),
, (refludan)

14

(unfractionated)
,
.

15


, ,

6)


, ,
/

aureus
:
) screening (
aureus )

) aureus,


) , ,
) :
-
- ()
-
.

16


2

4 (
),




2-4 (
)


,

2
(4 ).

36

, , 2

,
,
.

.
(MRSA)
MRSA. , gram (

aeruginosa) 3 4
.

(.. , .)
mantoux, mantoux

, , ,
, , ,


mantoux.
mantoux



.
.

, C HIV

17



.
3-6



C. 6


ELISA (RIBA).

HIV
.
screening HIV .

,
, :

18







( )

C
,

C

(inoculation)
/
(
).
AZT,
, ,
HIV.

.
0,1,6 0,1,2 12 .


(10mIU/ml).




anti-HBs 1, 2
6-12 .
(10mIU/ml).
6.

19

anti-HBs
<10mIU/ml.



.
-

C

. 5




/
.

7)
)
)


(
<100CFU/ml
<0,25 EU/ml).
(-) .


(Association for Advanced
Medical Instrumentation) 2

AAMI

<100

<0.1

200
<0.000001

(CFU/ML)

<2
<0.25
<0.03
<0.03

(IU/ML)


(mg/l)

0.0100
0.0100

0.0060

0.0060

0.0050

0.0050

0.1000

0.1000

0.0004

0.0004

0.0010

0.0010

2(0.02mmol/l)

2(0.05mmol/l)

0.1000
0.0140

0.1000
0.0140

AAMI

20

0.1000

0.1000

0.0200
0.2000
0.5000

0.0200
0.2000
0.5000

0.0050

0.0050

4(0.16mmol/l)

2(0.08mmol/l)

0.0002

0.0010

2.0000
8(0.2mmol/l)
0.0900

2.0000
2(0.08mmol/l)
0.0900

0.0050

0.0050

70(3.0mmol/l)
100
0.0020

50(2.2mmol/l)
100
0.0020

0.1000

0.1000


.
.

.


( )
.

.
()
.

/./

21

12



.

. (, , )
(, )

.
1
.

22


( )

( , PH, , )
.


.



.

on-line .

/
.

.

8)



Biofilm .


.

.

.


(.. 2m-).





.

European Best Practice Guidelines for Hemodialysis(Part 1)


European Best Practice Guidelines for Hemodialysis(Part 2)
Diagnosis prevention and treatment of central venus catheters infections in Hemodialysis
(Vanholder et al. NDT plus 2010)
Hemodialysis adequacy, NKF 2002
Contribution Nephrol 2007; 158 : 225-231
On line hemodiafiltration (technical options and best clinical practices) B.Cannaout. In
Roncocy, Cannaout B, Aljama P (eds) : Hemodiafiltration, Karger 2007, pp110-123

23

24

You might also like