维持性血液透析患者尿素清除指数多因素分析

Multivariate analysis of urea clearance index in maintenance hemodialysis patients from a single center

目的计算维持血液透析患者的单次尿素清除指数（Kt／V），记录透析过程中的血流量、超滤量、血红蛋白和体重指数（BMI）等指标，并分析这些指标对Kt／V的影响。方法选取我院血液净化中心维持血液透析3个月以上的终末期肾病患者135例，计算每个患者该次血液透析的Kt／V，Kt／V≥1．2为Kt／V达标组，Kt／V〈1．2为Kt／V不达标组，统计分析Kt／V与血流量、超滤量、血红蛋白、体重指数等指标的相关性。结果135例患者中，血流量（13=0．052）和超滤量（B=1．143）与单次血液透析的Kt／V呈正相关（P〈0．05），BMI（β=-0．404）和血红蛋白（β：-0．063）与单次血液透析的Kt／V呈负相关（P〈0．05）。结论血流量、BMI、超滤量和血红蛋白是单次血液透析Kt／V的重要影响因素。

Objective We calculated the single urea clearance index （Kt/V） value in maintenance hemodialysis patient by examination of the blood urea nitrogen（BUN） values before and after hemodialysis. Simultaneously we recorded indicators such as blood flow, ultrafiltration volume, hemoglobin, body mass index（BMI） and others,then analyzed these factors which may affect the Kt/V. Methods We recruited 135 maintenance hemodialysis patients with end stage renal disease（ESRD） who had received hemodialysis treatment for more than three months in our blood purification center. BUN value was tested before and after hemodialysis, then Kt/V was calculated. Kt/V ≥ 1.2 was in group up to the standard and Kt/V 〈 1.2 was in group down to the standard. Correlation between Kt/V and some indices including blood flow, ultrafiltration volume, hemoglobin, body mass index （BMI） and others was analyzed by multivariate analysis. Results In 135 patients,the Kt/V of a single dialysis was positively correlated with the blood flow（ 13 = O. 052） and uhrafiltration volume（ 13 = 1. 143 ）, and was negatively correlated with BMI（ 13 = - 0. 404） and hemoglobin （ 13 = - 0. 063 ）. Conclusion Blood flow, BMI, ultrafihration volume and hemoglobin are the important factors affecting the Kt/V of a single dialysis.