Tzamaloukas A H, Murata G H, Bernardini J, Malhotra D, Rao P, Piraino B, Oreopoulos D G
Veterans Affairs Medical Center and Department of Medicine, University of New Mexico School of Medicine, Albuquerque 87108, USA.
Perit Dial Int. 1999 Mar-Apr;19(2):165-9.
To compare raw (not normalized) and normalized urea and creatinine clearances between women and men on continuous ambulatory peritoneal dialysis (CAPD). To study whether potential gender differences are due to the normalization process.
Retrospective analysis of clearance studies.
Dialysis units of four academic medical centers.
The study included 302 subjects (135 women and 167 men) on CAPD with four daily exchanges and a 2-L exchange volume.
Measurement of urea and creatinine clearances (261 in women, 352 in men) by standard methods. Body water (the volume of distribution, V, for both urea and creatinine) was estimated by the Watson anthropometric formulas.
Comparison of raw and normalized clearances between women and men. Urea clearance was normalized by V (Kt/Vur), while creatinine clearances was normalized by both V (Kt/Vcr) and body surface area (BSA) (Ccr).
Mean values of weekly total (peritoneal plus renal) raw clearances were higher in men (urea clearance: women 67.1 L, men 77.4 L; Ccr: women 61.7 L, men 78.3 L). Raw renal clearances were higher in men, while raw peritoneal clearances were comparable. Mean weekly total Kt/Vur was higher in women (2.19 vs 1.94 in men), mean weekly total Kt/Vcr did not differ between the genders (women 2.01, men 1.95), while mean weekly Ccr was higher in men (73.0 vs 64.7 L/1.73 m2 in women). When clearances differed, the differences were significant at p < 0.001. Men had greater height and weight, while women had greater body mass index. On the average, V in men exceeded V in women by 31%, while BSA in men exceeded BSA in women by only 12%.
Normalization of clearances by V creates relatively higher clearance values in women, while normalization by BSA creates relatively higher clearance values in men. Thus the normalization process may create artificial differences in the normalized clearances between genders.
比较持续非卧床腹膜透析（CAPD）患者中男性和女性的未校正（非标准化）及校正后的尿素和肌酐清除率。研究潜在的性别差异是否归因于标准化过程。
清除率研究的回顾性分析。
四个学术医学中心的透析单元。
该研究纳入了302名接受CAPD治疗、每日进行4次交换且交换量为2升的受试者（135名女性和167名男性）。
采用标准方法测量尿素和肌酐清除率（女性261例，男性352例）。通过沃森人体测量公式估算身体水分（尿素和肌酐的分布容积V）。
比较男性和女性未校正及校正后的清除率。尿素清除率通过V进行校正（Kt/Vur），而肌酐清除率通过V（Kt/Vcr）和体表面积（BSA）（Ccr）进行校正。
男性每周总的（腹膜加肾脏）未校正清除率平均值较高（尿素清除率：女性67.1升，男性77.4升；Ccr：女性61.7升，男性78.3升）。男性的肾脏未校正清除率较高，而腹膜未校正清除率相当。女性每周总的Kt/Vur平均值较高（女性为2.19，男性为1.94），两性之间每周总的Kt/Vcr平均值无差异（女性为2.01，男性为1.95），而男性的每周Ccr平均值较高（女性为64.7升/1.73平方米，男性为73.0升/1.73平方米）。当清除率存在差异时，差异在p<0.001水平具有统计学意义。男性身高和体重更大，而女性体重指数更大。平均而言，男性的V比女性的V高31%，而男性的BSA仅比女性的BSA高12%。
通过V进行清除率标准化会使女性的清除率值相对较高，而通过BSA进行标准化会使男性的清除率值相对较高。因此，标准化过程可能会在两性的标准化清除率中产生人为差异。
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