夜间透析：维持肾脏功能的新趋势.doc

【medical-news】夜间透析：维持肾脏功能的新趋势Nocturnal Dialysis: A Better Way to Kidney HealthPatients find quality of life is greatly improved, too FRIDAY, June 20 (HealthDay News) - While dialysis is a lifesaving treatment for many people with kidney disease, it can be very inconvenient. And the process just doesnt clean the blood as effectively as well-functioning kidneys do.But, nocturnal dialysis - a newer option - is starting to change all that.Nocturnal dialysis, not surprisingly, is dialysis performed at night. Its usually done at home, though some people opt for in-center nighttime treatments. The big benefit to nocturnal dialysis is that the blood is filtered for about eight hours at a time, instead of the standard two-and-a-half to three hours. And, because its usually done at home, it can be performed more frequently than the usual three times weekly. One of the major problems with dialysis done in the traditional sense is that it tries to provide a lot of therapy in a short period of time, and its difficult to clear toxins and fluid in that time, said Dr. Dylan Steer, a nephrologist with Scripps Memorial Hospital in La Jolla, Calif. Nocturnal dialysis provides a greater amount of toxin removal over a long period of time.Dr. Robert Provenzano, chairman of the department of nephrology at St. John Hospital in Detroit, added: The advantage of nighttime dialysis is that if you add the hours up, you get more dialysis delivered. Weekly, you get between 10 and 12 hours on regular dialysis, but on nighttime dialysis you get about 24. The blood is cleaner, and a lot of the restrictions placed on dialysis patients are lessened. They often use less medicine and can have a more liberal diet. The more dialysis, the better. Normally functioning kidneys filter about 200 quarts of fluid each day, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. All that filtering produces about two quarts of waste and some excess water. If the kidneys cant filter the fluid, waste products build up, making you ill.Dialysis machines attempt to artificially do the work of your kidneys. Some of your blood is removed from your body and filtered through the dialysis machine, which removes toxins from the blood before returning it to your body.Normally, people travel to a dialysis center and spend about three-and-a-half hours hooked up to the dialysis machine three times a week, usually during the day. Recently, some centers have begun to offer nocturnal dialysis. Instead of coming during the day, patients arrive in the evening and are dialyzed for about eight hours while they sleep at the center, usually three times a week. Another alternative is at-home nocturnal dialysis. At-home dialysis is an option for many people, according to Provenzano, who added that many of his patients whove chosen this option tell him they wish theyd started at-home dialysis sooner. The machines are much smaller, and all you have to do is plop a cartridge in. Its much less complicated than it used to be, he said.The benefits to nighttime dialysis are clear. A recent study in the Journal of the American Medical Association found that nocturnal dialysis improved the heart health of dialysis patients, reduced the need for some blood pressure medications, and improved quality of life. Dialysis patients need to know that nocturnal dialysis is one of a number of options that they have for their dialysis, Steer said. Both Steer and Provenzano said they havent had any problems getting insurers to cover nocturnal dialysis. This is available. Its something patients can do themselves that improves the amount of delivered dialysis, and patients do fantastic on it, Provenzano said. /Article.asp?AID=612133 夜间透析：更好地维护肾脏健康患者的生活质量也改善不少。周五，6月20日（健康新闻）虽然对于很多肾脏疾病的患者来说，透析是一种维持生命的方法，但是它极为不便，效果也是远远不及正常肾脏。但是，夜间透析一种新的选择将要开始改变这一切。夜间透析，顾名思义，就是在夜间进行的透析治疗。一般是在家里进行的，当然，也有人选择在透析中心进行这样的治疗。夜间透析最大的好处是一次透析可以进行8个小时，而不是以往白天透析的2.53个小时。同时，由于是在家里进行，透析的频率也比正常的一周三次更多。加州拉霍亚Scripps Memorial医院的肾脏病学家Dylan Steer博士说：“常规进行的透析治疗就是要在短时间内进行大量的治疗，但其实在这么短的时间内完全清除毒素和水分是很困难的，而夜间治疗则可以在较长的时间内轻松就做到。” 底特律St. John医院的Robert Provenzano博士说，“夜间透析的好处是透析的时间可以延长，每周，常规透析只能进行1012小时，而夜间透析的时间可以长达24小时；患者的血液更清洁，透析患者的很多限制也可以解除，他们可以少用药物，饮食也更为自由；透析时间越长，效果就越好。”根据美国国立糖尿病、消化和肾脏疾病研究机构的研究，功能正常的肾脏每天约能过滤200升体液，最后会产生约两升废物和一些多余的水分，如果肾脏不能正常过滤体液，那废物就会在体内堆积，人就会生病。透析就是模拟肾脏的工作患者的血液会在体外经过透析设备的过滤，将毒素清除，然后再将血液回输到患者的体内。常规情况下，患者一般是在白天到透析中心进行治疗，每次约三个半小时“拴”在透析设备上，每周三次。最近，有一些透析中心开始提供夜间透析的服务。患者不是白天来做透析的，他们现在是晚上来到中心，在那里进行约8个小时的透析，当然，也是在那里睡觉。同样，一周三次。另外还有一种选择就是在家里进行这种夜间透析，Provenzano博士说，这是很多患者的选择，很多他的病人就选择了这种方法，而且还说，如果他们