REFINING THE MODEL OF UREA KINETICS - COMPARTMENT EFFECTS

被引：36

作者：

DEPNER, TA

机构：

[1] The Department of Medicine, Division of Nephrology, University of California, Davis

[2] School of Medicine, Davis, California

来源：

SEMINARS IN DIALYSIS | 1992年 / 5卷 / 02期

关键词：

D O I：

10.1111/j.1525-139X.1992.tb00133.x

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：

A 70-year-old female with chronic congestive heart failure requires maintenance hemodialysis because of end-stage diabetic nephropathy. She is dialyzed on Monday, Wednesday, and Friday for 2 hours using a dialyzer with an average urea clearance of 250 ml/min. Dry weight is 50 kg. Predialysis blood urea nitrogen (BUN) on Wednesday is 50 mg/dl; postdialysis BUN is 15 mg/dl. A single-compartment, variable-volume model of urea kinetics revealed the following: 1.5 hours of dialysis are sufficient to maintain Kt/V at 1.1/dialysis; protein catabolism is 0.92 g/kg/day; her volume of urea distribution is 43% of body weight. Provided the blood access device and dialysis equipment are functioning properly and the blood specimens are drawn and measured correctly, are the model predictions valid? The discussion to follow will show that the predictions are probably not valid. The patient is likely to have hemodialysis-induced nonuniform distribution of urea, a multicompartment effect that can alter the single-compartment predictions, generating a false assurance of dialysis adequacy.

引用

页码：147 / 154

页数：8

共 42 条

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