Golper T A
University of Arkansas for Medical Sciences, 4301 West Markham, Mail Slot 501, Little Rock, AK 72205, USA.
J Am Soc Nephrol. 1998 Dec;9(12 Suppl):S107-11.
The National Kidney Foundation-Dialysis Outcome Quality Initiative Peritoneal Dialysis Adequacy Clinical Practice Guideline 1 and Appendix A offered the first formal in-depth discussion of the concept of incremental dialysis (1). The context of the work group's concern was that it is paradoxical that we nephrologists have focused on optimizing urea clearance for end-stage renal disease patients, but not in pre-end-stage renal disease patients. Because so much evidence from the collective peritoneal dialysis experience suggested that a weekly Kt/Vurea of 2.0 is appropriate, the National Kidney Foundation-Dialysis Outcome Quality Initiative Peritoneal Dialysis Adequacy Work Group recommended that when the residual renal Kt/Vurea drops below 2.0, supplemental Kt/Vurea should be added incrementally by dialysis. This article describes this concept in more detail.
美国国家肾脏基金会 - 透析预后质量倡议腹膜透析充分性临床实践指南1及附录A首次对增量透析的概念进行了正式深入的讨论（1）。工作组关注的背景是，矛盾之处在于我们肾脏病学家一直专注于优化终末期肾病患者的尿素清除率，却未关注终末期肾病前期患者。鉴于腹膜透析的总体经验中有诸多证据表明每周尿素清除率（Kt/Vurea）为2.0是合适的，美国国家肾脏基金会 - 透析预后质量倡议腹膜透析充分性工作组建议，当残余肾尿素清除率（Kt/Vurea）降至2.0以下时，应通过透析逐步增加补充性尿素清除率（Kt/Vurea）。本文将更详细地描述这一概念。
