透析后尿素反跳和残余肾功能对KT/V及PCR的影响

A study of residual renal function and urea rebound in the calaulation of KT/V and PCR

为了评价影响透析充分与否的因素，本文研究了65例慢性血液透析患者，透析后尿素反跳和残余肾功能对尿素、KT／V-尿素和PCRE响．结果表明．尿素和肌酐的反跳率取决于溶质的分子量、残余肾功能以及透析时间；血磷反跳与残余肾功能无关．在无残余肾功能的患者中，计算KT／V-尿素和肌酐生成率必须考虑反跳因素。否则，4h透析，KT／V-尿素和肌酐生成率分别可能被过高评估为15％、20％，因此，适当调整影响因素，才能达到透析充分的目标。

The study was undertaken to determine the implication of urea rebound and residual renal function (RRF) on the calculation of KT/V-urea and PCR. 65 patients (37 males and 28 females ) on chronic heamedialysis (CHD) they were divided into groups as fol-lows: I residual renal function Ccr＞1ml/ min (n = 14, mean duration of CHD 26 ± 8 months), Ⅱ residual renal function Ccr ＜lml/min (n = 51； mean duration of CHD 29 ± 6 months). The results suggest that one hour after the end of dialysis session, urea and creatinine rebound rate in patient with-out RRF was significantly higher than inpatients with RRF (P＜0. 05 ). In patient without RRF,creatinine generation rate and KT/V-urea calculated without rebound were significantly higher than calculated with rebound (P＜0.001 ). On the contrary,calculation of urea generation and PCR was not affected by these parameters. We con-cluded that rebound rate magnitude of urea and creatinine is dependent on solute molec-ular weight, RRF, and probably on dialysis duration. Whereas rebound rate magnitude of phosphate is not affected and in patients without RRF, rebound equilibration should be taken into account in the calculation of creatinine generation rate and KT/V-urea.Otherwise, for a four-hour treatment, there would be an overestimation of KT/V-urea by about 15%, and creatinine generation rate by about 20%.