PrOširena hemODijaliza: OsnOVni PrinciPi i klinički značaj. (Bosnian)

EXPANDED HEMODIALYSIS: BASIC PRINCIPLES AND CLINICAL SIGNIFICANCE. (English)

Expanded hemodialysis is a method of treatment to replace kidney function, which effectively removes uremic toxins of middle molecular weight from the blood of the patients with the end stage of chronic kidney disease. Two basic principles of removing uremic toxins during an expanded hemodialysis session are diffusion and convection. The basis of diffusion is the concentration gradient, and the basis of convection is internal filtration (covective transport). Increased MCO membrane sieving capacity and high internal filtration provide high clearance of middle molecular weight uremic toxins. Expanded hemodialysis prevents the development of microinflammation, malnutrition, resistance to the action of erythropoietin, amyloidosis, accelerated atherosclerosis and atherosclerotic cardiovascular diseases in the population of patients treated with regular dialysis. The task of the nephrologist is to evaluate different dialysis modalities that are available and to select the optimal dialysis modality for the treatment of each patient individually, i.e., the individualization of dialysis treatment. [ABSTRACT FROM AUTHOR]

Proširena hemodijaliza je metoda lečenja za zamenu funkcije bubrega, koja efikasno uklanja uremijske toksine srednje molekulske mase iz krvi bolesnika sa završnim stadijumom hronične bolesti bubrega. Dva osnovna principa uklanjanja uremijskih toksina u toku sesije proširene hemodijalize јеsu difuzija i konvekcija. U osnovi difuzije je koncentracijski gradijent, a u osnovi konvekcije unutrašnja filtracija (konvektivni transport). Povećan kapacitet prosejavanja Medium Cut-Off (MCO) membrane i visoka unutrašnja filtracija obezbeđuju visok klirens uremijskih toksina srednje molekulske mase. Proširena hemodijaliza sprečava razvoj mikroinflamacije, malnutricije, rezistencije na dejstvo eritropoetina, amiloidoze, ubrzane ateroskleroze i aterosklerotskih kardiovaskularnih bolesti u populaciji bolesnika koji se leče redovnom dijalizom. Zadatak nefrologa je da proceni različite modalitete dijalize koji su dostupni i da odabere optimalni modalitet dijalize za lečenje svakog bolesnika pojedinačno (individualizacija lečenja dijalizom). [ABSTRACT FROM AUTHOR]

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