在线尿素清除率监测估算终末期肾病患者血液透析尿素清除指数的研究

Estimation of dialysis dose (Kt/V Urea) by online clearance monitoring in hemodialysis patients with end stage of renal disease

目的探讨在线尿素清除率监测值与取血法检测尿素清除指数(Kt/V)之间的关系,并建立由在线尿素清除率推导Kt/V的计算公式。方法测定74例稳定血液透析患者的在线尿素清除率监测值与取血法Kt/V值。首先通过相关分析得出在线尿素清除率监测值与取血法Kt/V值的相关性,然后通过临床参数的多因素线性回归分析得出各临床参数之间的比例关系,根据这种比例关系建立由在线尿素清除率推导Kt/V的计算公式。结果在线尿素清除率监测的Kt/V值比传统取血法计算的spKt/V值低,直线相关分析显示,二者具有良好的相关性(r=0.690,P<0.001),通过建立影响Kt/V值临床参数的回归方程,在线尿素清除率的计算可以推导出Kt/V值。结论在线尿素清除率监测值与取血法Kt/V之间存在较高的相关性,可应用在线尿素清除率监测值估算取血法Kt/V值。

Objective To investigate the relationship between dialysis dose measured by online clearance monitoring（OCM）and Kt/V Urea from pre-and post-dialysis blood-urea samples,and set up a prediction rule to estimate spKt/V by OCM.Methods OCM and Kt/V Urea data from 74 hemodialysis patients were measured.The relationship between OCM and Kt/V Urea was analyzed by correlation assay.Clinical parameters were put into the linear regression formula,based on which the prediction rule was calculated to estimate Kt/V Urea by OCM.Results Dialysis dose measured by OCM was lower than Kt/V Urea,and they had close relationship（r=0.690,P〈0.001）.Based on clinical parameters,Kt/V Urea could be calculated by OCM.Conclusion There is a close relationship between OCM and Kt/V Urea.And based on clinical characters,Kt/V Urea could be calculated by OCM.