ESTIMATION OF TREATMENT DOSE IN HIGH-EFFICIENCY HEMODIALYSIS

被引:72
作者
SMYE, SW [1 ]
DUNDERDALE, E [1 ]
BROWNRIDGE, G [1 ]
WILL, E [1 ]
机构
[1] ST JAMESS UNIV HOSP,DEPT RENAL MED,LEEDS LS9 7TF,ENGLAND
来源
NEPHRON | 1994年 / 67卷 / 01期
关键词
HIGH-EFFICIENCY HEMODIALYSIS; UREA REBOUND; DIALYSIS DOSE ESTIMATION;
D O I
10.1159/000187883
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Blood urea concentration is artificially low immediately following high-efficiency dialysis of duration T and will rise ('rebound') due to the continued diffusion of urea from the intracellular to the extracellular space. This leads to an overestimate of the efficiency of the dialysis given by KT/V (where V is the total distribution volume of urea and K is the urea clearance of the dialyser) if the true equilibrium blood concentration of urea is not used in the calculation of KT/V by the single-pool urea kinetic model (UKM). The measurement of the equilibrium urea concentration entails an additional blood sample 60 min after dialysis, but an estimate may be calculated using a blood sample taken 80 min following the start of dialysis together with an approximate formula derived from the 2-pool model. In 14 patients, an average error in the calculation of KT/V of 35% (range 19-75%) by the single-pool UKM was reduced to 13% (range 1-55%, but 8 measurements to <7%) using the approximate technique. It is concluded that the approximate technique significantly improves the accuracy of dose estimation in high-efficiency dialysis without inconveniencing the patient.
引用
收藏
页码:24 / 29
页数:6
相关论文
共 10 条
[1]   UREA KINETICS AND CLINICAL-EVALUATION OF THE HEMODIALYSIS PATIENT [J].
BUUR, T ;
TIMPKA, T ;
LUNDBERG, M .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1990, 5 (05) :347-351
[2]   MATHEMATICAL-MODELING OF HEMODIALYSIS IN CHILDREN [J].
EVANS, JHC ;
SMYE, SW ;
BROCKLEBANK, JT .
PEDIATRIC NEPHROLOGY, 1992, 6 (04) :349-353
[3]   A MECHANISTIC ANALYSIS OF THE NATIONAL COOPERATIVE DIALYSIS STUDY (NCDS) [J].
GOTCH, FA ;
SARGENT, JA .
KIDNEY INTERNATIONAL, 1985, 28 (03) :526-534
[4]  
LOPOT F, 1991, NEPHROL DIAL TRANSPL, V3, P86
[5]   CAUSES, KINETICS AND CLINICAL IMPLICATIONS OF POST-HEMODIALYSIS UREA REBOUND [J].
PEDRINI, LA ;
ZEREIK, S ;
RASMY, S .
KIDNEY INTERNATIONAL, 1988, 34 (06) :817-824
[6]  
SARGENT JA, 1980, KIDNEY INT, V18, pS2
[7]  
SARGENT JA, 1983, KIDNEY INT S13, V23, pS19
[8]   PEDIATRIC HEMODIALYSIS - ESTIMATION OF TREATMENT EFFICIENCY IN THE PRESENCE OF UREA REBOUND [J].
SMYE, SW ;
EVANS, JHC ;
WILL, E ;
BROCKLEBANK, JT .
CLINICAL PHYSICS AND PHYSIOLOGICAL MEASUREMENT, 1992, 13 (01) :51-62
[9]   KINETIC MODELING OF HEMODIALYSIS, HEMOFILTRATION, AND HEMODIAFILTRATION [J].
SPRENGER, KBG ;
KRATZ, W ;
LEWIS, AE ;
STADTMULLER, U .
KIDNEY INTERNATIONAL, 1983, 24 (02) :143-151
[10]  
YASMURA S, 1983, AM J PHYSIOL, V244, pR36