血液透析剂量计算新方法的准确性评价

A. Azar
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引用次数: 3

摘要

Kt/V值反映血液透析(HD)的剂量。然而,由于现有几种计算透析剂量的方法,对于同一组透析前/透析后血尿素浓度,Kt/V值实际上可能是不同的。方法在本文的研究中,推导了另一个公式来计算透析前和透析后的BUN的Kt/V。我们前瞻性地比较了使用这个新公式获得的Kt/V值和通过其他现有公式获得的Kt/V值,以了解依赖后一种方法是否可能导致过量或不足的透析方案的错误。对268名透析患者的数据进行了处理。结果除lowrie (p = 0.112)、Keshaviah (p = 0.069)、Daugirdas第一代(p = 0.059)、Basile (p = 0.102)、Ijely (p = 0.286)和Daugirdas第二代(p = 0.709)计算的Kt/V (Kt/Vest)值与其他模型计算的Kt/V值有统计学差异(p < 0.05)。与Daugirdas二代公式相关性最佳(R = 0.958, R2 = 0.919)。结论由于Kt/Vest与Daugirdas第二代Kt/V之间的相关性最好,因此这两个模型比其他模型更准确。
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Estimation of Accurate and New Method for Hemodialysis Dose Calculation
Background The Kt/V value demonstrates the dose of hemodialysis (HD). However, because of several existing methods for calculating delivered dialysis dose, Kt/V values can, in fact, be different for the same set of pre-/post-dialysis blood urea concentrations. Methods In the study presented here, another formula was derived for calculating Kt/V from the pre- and post-dialysis BUN. We prospectively compared the Kt/V values obtained using this new formula and the Kt/V values obtained via the other existing formulae to see whether reliance on the latter approach was likely to lead to errors in over- or underprescribing dialysis regimens. Data were processed on 268 dialysis patients. Results The estimated Kt/V (Kt/Vest) values were statistically different (p < 0.05) from the calculated Kt/V values from other models, except for those Kt/V values calculated according to the lowrie (P = 0.112), Keshaviah (P = 0.069), Daugirdas First Generation (P = 0.059), Basile (P = 0.102), Ijely (P = 0.286) and Daugirdas Second Generation (P = 0.709). The best correlations were seen with the Daugirdas second generation formula (R = 0.958 and R2 = 0.919). Conclusion Since the best correlations were seen between Kt/Vest and the Daugirdas second generation Kt/V we can demonstrate that these two models are more accurate than the other models.
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