Panagoutsos Stelios A, Yannatos Evangelos V, Passadakis Ploumis S, Thodis Elias D, Galtsidopoulos Omiros G, Vargemezis Vassilis A
Democritus University of Thrace, Division of Nephrology, G.D. Hospital of Alexandroupolis, Greece.
Ren Fail. 2002 Sep;24(5):615-21. doi: 10.1081/jdi-120013965.
There is good evidence that by improving dialysis adequacy, morbidity, and mortality of hemodialysis (HD) patients decrease. Dialysis adequacy has also been related to the better control of arterial blood pressure (BP), anemia and improvement of patients' nutritional status. This is a self-control study of 34 HD patients, (23 males, 11 females), aged 52.6 +/- 15.5 years, HD duration 55.9 +/- 61.2 months, referring to the effect of increasing delivered dialysis dose, over a two-year period, on their clinical and laboratory parameters. Delivered HD dose increased statistically significantly: Urea reduction ratio (URR) increased from 52 +/- 8 to 71 +/- 7% and Kt/V from 0.93 +/- 0.19 to 1.55 +/- 0.29 (p < 0.001). Hb increased statistically significantly from 10.4 +/- 1.7 to 11.0 +/- 1.3 g/dL (p < 0.05) while no difference has been noticed in weekly EPO dose. Both systolic and diastolic BP decreased statistically significantly (from 147 +/- 24 to 133 +/- 25mmHg and from 73 +/- 12 to 66 +/- 13 mmHg respectively, p = 0.001). Serum albumin increased from 4.3 +/- 0.4 to 4.6 +/- 0.3g/dL (p = 0.002) and nPCR from 0.93 +/- 0.16 to 1.20 +/- 0.17 (p < 0.001). We conclude that increasing dialysis dose results in both clinical and laboratory improvement regarding hypertension, nutritional status and control of HD patients' anemia.
有充分证据表明，通过提高透析充分性，血液透析（HD）患者的发病率和死亡率会降低。透析充分性还与更好地控制动脉血压（BP）、贫血以及改善患者营养状况有关。这是一项对34例HD患者（23例男性，11例女性）进行的自我对照研究，患者年龄为52.6±15.5岁，HD疗程为55.9±61.2个月，研究了在两年时间内增加透析剂量对其临床和实验室参数的影响。透析剂量显著增加：尿素清除率（URR）从52±8%增加到71±7%，Kt/V从0.93±0.19增加到1.55±0.29（p<0.001）。血红蛋白（Hb）从10.4±1.7g/dL显著增加到11.0±1.3g/dL（p<0.05），而每周促红细胞生成素（EPO）剂量无差异。收缩压和舒张压均显著降低（分别从147±24mmHg降至133±25mmHg和从73±12mmHg降至66±13mmHg，p = 0.001）。血清白蛋白从4.3±0.4g/dL增加到4.6±0.3g/dL（p = 0.002），标准化蛋白分解代谢率（nPCR）从0.93±0.16增加到1.20±0.17（p<0.001）。我们得出结论，增加透析剂量可使HD患者在高血压、营养状况和贫血控制方面的临床和实验室指标得到改善。
