Sanlidag C, Cavdar C, Sifil A, Hastaoglu S, Uretmen P, Camsari T
CAPD Center, Department of Nephrology, Dokuz Eylül University Hospital, Izmir, Turkey.
Perit Dial Int. 1999;19 Suppl 2:S514-6.
Dialysis adequacy has gained particular interest for the assessment of the quality of dialysis in patients undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). Kt/V is used as a test of dialysis adequacy in HD and CAPD patients. The aim of this study was to compare two different Kt/V methods in CAPD patients. A practical method for the calculation of Kt/V will be suggested at the end of this prospective study. The study group included 28 patients. Each patient received CAPD therapy four times per day. During the study, CAPD dialysate samples for a period of 24 hours were obtained by two different methods. One is a modified method for obtaining samples by the patient at home; the other is the conventional method. For study purposes only, we told the patients using the modified method to bring all the bags to the center (contrary to the aim of the modified method). In the first method (modified method), CAPD patients collected 24-hour dialysate and urine samples at home and brought all of the materials to the hospital. A 10 mm3 dialysate sample was drawn from each CAPD dialysate bag, and then a total of 40 mm3 dialysate was mixed in a beaker. A sample of 10 mm3 of dialysate was taken from the mixture in the beaker, and then this dialysate sample, urine, and 5 mm3 venous blood were sent to the laboratory for urea nitrogen (UN) and creatinine level determinations. In addition to these tests, 24-hour dialysate and urine volumes and the patients' weight and height were measured, and Kt/V values were calculated. In the second method (classic method), all the bags from the 24-hour period were collected and mixed in a big bucket, and then a 10 mm3 sample was taken. The remaining procedures were the same as for the first method. Mean Kt/V values were calculated separately for the two methods and were found to be 2.48 by the modified method and 2.52 by the classic method. The results of the two methods were compared with the Wilcoxon paired t-test, which showed no statistically significant difference (p = 0.5228). In conclusion, two different Kt/V methods can be used in CAPD patients. However, the modified method is easily performed, and CAPD patients can collect and take the dialysate and urine samples at home, and bring these materials to the renal unit without transportation problems.
透析充分性已成为评估接受血液透析（HD）和持续性非卧床腹膜透析（CAPD）患者透析质量的特别关注点。Kt/V被用作HD和CAPD患者透析充分性的一项检测指标。本研究的目的是比较CAPD患者中两种不同的Kt/V计算方法。在这项前瞻性研究结束时，将提出一种计算Kt/V的实用方法。研究组包括2８名患者。每位患者每天接受4次CAPD治疗。在研究期间，通过两种不同方法获取24小时的CAPD透析液样本。一种是患者在家自行获取样本的改良方法；另一种是传统方法。仅出于研究目的，我们告知使用改良方法的患者将所有袋子带到中心（这与改良方法的目的相悖）。在第一种方法（改良方法）中，CAPD患者在家收集24小时的透析液和尿液样本，并将所有材料带到医院。从每个CAPD透析液袋中抽取10立方毫米的透析液样本，然后将总共40立方毫米的透析液在一个烧杯中混合。从烧杯中的混合物中取出10立方毫米的透析液样本，然后将该透析液样本、尿液和5立方毫米的静脉血送至实验室测定尿素氮（UN）和肌酐水平。除了这些检测外，还测量了24小时的透析液和尿量以及患者的体重和身高，并计算了Kt/V值。在第二种方法（经典方法）中，收集24小时期间的所有袋子并在一个大桶中混合，然后抽取10立方毫米的样本。其余步骤与第一种方法相同。分别计算两种方法的平均Kt/V值，改良方法得出的结果为2.48，经典方法得出的结果为2.52。两种方法的结果通过Wilcoxon配对t检验进行比较，结果显示无统计学显著差异（p = 0.5228）。总之，两种不同的Kt/V方法均可用于CAPD患者。然而，改良方法操作简便，CAPD患者可以在家中收集并采集透析液和尿液样本，且将这些材料带到肾脏科不存在运输问题。
