Hémodialyse à domicile : il y a-t-il encore une place pour le haut débit de dialysat ?

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Publiée sept. 23, 2018
Thierry Petitclerc

Résumé

(English abstract at the end)

La disponibilité en France, durant la dernière décennie, de moniteurs d’hémodialyse à bas débit de dialysat, spécifiquement adaptés pour la dialyse quotidienne (5 à 6 séances par semaine), est contemporaine d’un véritable renouveau de l’hémodialyse à domicile. Si les bénéfices cliniques de l’hémodialyse quotidienne à haut débit de dialysat et de l’hémodialyse longue nocturne trihebdomadaire, qui sont deux modalités d’hémodialyse intensive, ont bien été démontrés, ils le sont beaucoup moins en ce qui concerne l’hémodialyse à bas débit de dialysat. Ainsi certains patients pourraient-ils encore souhaiter utiliser des moniteurs classiques d’hémodialyse afin de pouvoir restreindre le nombre de séances (et donc de ponctions de l’abord vasculaire) à 3 par semaine (ou à 1 jour sur 2) ou bénéficier d’une modalité d’hémodialyse intensive.

Abstract

The availability in France, for the last decade, of low dialysate flow rate hemodialysis monitors, specifically adapted for daily hemodialysis (5 to 6 sessions per week), is contemporary with a real renewal of home hemodialysis. The clinical benefits of daily hemodialysis with high dialysate flow and of thrice-weekly long nocturnal hemodialysis, which are two intensive hemodialysis modalities, have been demonstrated ; however they are less well demonstrated with low dialysate flow hemodialysis. Thus, some patients may still wish to use conventional hemodialysis monitors in order to limit the number of sessions (and therefore the number of vascular punctures) to 3 per week (or every other day) or wish to benefit from a modality of intensive hemodialysis.

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Keywords

hémodialyse à domicile, hémodialyse intensive, hémodialyse quotidienne, HDQ, Kt/V standart

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