Blake P G, Balaskas E, Blake R, Oreopoulos D G
Toronto Hospital.
Adv Perit Dial. 1992;8:65-70.
The application of urea kinetics to CAPD is controversial. Additional data is presented from our recent study on this topic. Different methods of calculating KT/V and normalized protein catabolic rate (PCRN) are compared and KT/V is shown to be on average 6.5% higher when V is calculated by Watson's formulae instead of by body weight alone. This discrepancy increases with time. It is also shown that standard methods may overestimate KT and underestimate PCRN. KT/V and PCRN by these different methods do not correlate with clinical outcomes. However, if V is calculated by Watson's formulae, there is a significant excess of deaths when KT/V is under 0.5 (weekly KT/V under 1.5). Survival curves show that neither initial KT/V nor PCRN predict failure on CAPD.
尿素动力学在持续性非卧床腹膜透析(CAPD)中的应用存在争议。本文给出了我们近期关于该主题研究的更多数据。比较了计算KT/V和标准化蛋白分解代谢率(PCRN)的不同方法,结果显示,当采用沃森公式而非仅根据体重来计算V时,KT/V平均高出6.5%。这种差异会随着时间增加。研究还表明,标准方法可能高估KT并低估PCRN。通过这些不同方法得出的KT/V和PCRN与临床结果并无关联。然而,如果采用沃森公式计算V,当KT/V低于0.5(每周KT/V低于1.5)时,死亡人数会显著增加。生存曲线表明,初始KT/V和PCRN均无法预测CAPD治疗失败。