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持续性非卧床腹膜透析患者如何合理选择透析剂量 |
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俞雨生 沈克勤 樊荣 胡伟新 姚小丹 唐政 季大玺 黎磊石
【摘要】 目的 前瞻性观察了不同透析效能与透析剂量的关系，从而寻找出适合国人特点的透析剂量。方法 对44例病人共134例次测定按NCDS标准分为充分(44.0%)、临界(23.1%)及不充分(32.8%)三组，观察各组病人之间尿素KT/V、肌酐清除率、蛋白质表现率和血浆白蛋白、残余肾功能(RRF)、透析总量(PV)及单位体表面积透析剂量(PV/BSA)改变及相互关系。结果 三组病人在上述指标上有明显的差异(P＜0.001)。分析PV与PV/BSA反映透析效能诸因素之间的相关性显示，后者较前者更为显著(P＜0.01)。分析透析充分组病人PV/BSA与RRF之间的Pearson相关系数发现，合理的透析剂量应为：PV(L/d)=(5.6-0.24×RRF)×BSA。结论 所有腹透病人应采取个体化的透析剂量，以上述公式计算透析剂量，绝大多数病人能保持理想的透析效能。
【关键词】 腹膜透析 肾功能衰竭，慢性
How much peritoneal dialysis is required for Chinese people to maintain dialysis adequacy? Yu Yusheng, Shen Keqin, Fan Rong, et al. Research Institute of Nephrology Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002
【Abstract】 Objective To evalute the relationship between the dialysis adequacy and dialysis dosage and aid to prescribe or monitor dialysis dose. Methods A prospective study with 134 times of observation was carried out in 46 stable peritoneal dialysis patients. All patients were divided into adequacy in between and inadequacy groups based on the criteria used by the National Cooperation Dialysis Study in USA. Multiple univariate ANOVA and Pearson R coefficients were performed according to the standard procedures on dialysate volume and adequacy data. Results There was a marked difference in peritoneal dialysate volume (PV) as compared with peritoneal dialysate volume/body surfase area (PV/BSA) for the three groups (P<0.05 vs P<0.0001). Univariate analysis of the relationship between the dialysis dosage and urea KT/V, Alb and nPNA showed that PV/BSA correlated positively with urea KT/V, Alb and nPNA (r=0.53-0.83, P<0.05～0.01), while PV correlated positively only with urea KT/V (r=0.48, P<0.05). PV/BSA coorelated more significantly with urea KT/V than PV, so it was more influencing on the dialysis adequacy. The relationship between PV/BSA and RRF was performed in adequacy group patients with univariate analysis, the Pearson[1] [2] 下一页
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