一种预测腹膜透析中血浆钠浓度变化的新公式。
A new formula for predicting alterations in plasma sodium concentration in peritoneal dialysis.
作者信息
Nguyen Minhtri K, Kurtz Ira
机构信息
Div. of Nephrology, David Geffen School of Medicine at UCLA, Rm. 7-155 Factor Bldg., 10833 Le Conte Ave., Los Angeles, CA 90095, USA.
出版信息
Am J Physiol Renal Physiol. 2005 Jun;288(6):F1113-7. doi: 10.1152/ajprenal.00387.2004. Epub 2004 Dec 29.
Alterations in the plasma water sodium concentration ([Na+]pw) result from changes in the total exchangeable sodium (Na e), total exchangeable potassium (K e), and total body water (TBW). The empirical relationship between the [Na+]pw and Na e, K e, and TBW was originally demonstrated (Edelman IS, Leibman J, O'Meara MP, and Birkenfeld LW. J Clin Invest 37: 1236-1256, 1958), where [Na+]pw = 1.11(Na e + K e)/TBW - 25.6 (Eq. 1). Based on Eq. 1, alterations in the [Na+]pw can be predicted by considering changes in the mass balance of Na+, K+, and H2O. In accounting for the mass balance of Na+, K+, and H2O in patients on peritoneal dialysis, considerations must also be taken to determine the modulating effect of dialysate clearance of Na+ and K+ and fluid changes resulting from this therapeutic modality on the [Na+]pw. In this article, we derive a new formula for predicting alterations in the plasma Na+ concentration ([Na+]p) in patients on peritoneal dialysis, taking into consideration the empirical relationship between the [Na+]pw and Na e, K e, and TBW (Eq. 1) as well as changes in mass balance of Na+ + K+ and H2O.
血浆水钠浓度（[Na⁺]pw）的改变是由可交换钠总量（Na e）、可交换钾总量（K e）和总体水（TBW）的变化引起的。[Na⁺]pw与Na e、K e和TBW之间的经验关系最初由Edelman IS、Leibman J、O'Meara MP和Birkenfeld LW（《临床研究杂志》37: 1236 - 1256, 1958）证明，其中[Na⁺]pw = 1.11(Na e + K e)/TBW - 25.6（公式1）。基于公式1，[Na⁺]pw的改变可以通过考虑Na⁺、K⁺和H₂O的质量平衡变化来预测。在计算腹膜透析患者的Na⁺、K⁺和H₂O的质量平衡时，还必须考虑确定透析液中Na⁺和K⁺清除率以及这种治疗方式导致的液体变化对[Na⁺]pw的调节作用。在本文中，我们推导了一个新的公式，用于预测腹膜透析患者血浆钠浓度（[Na⁺]p）的改变，该公式考虑了[Na⁺]pw与Na e、K e和TBW之间的经验关系（公式1）以及Na⁺ + K⁺和H₂O的质量平衡变化。
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