Nakagawa S, Inoue A, Okuda K, Ogura M, Kuriyama R, Gotou K, Sakurai S, Hoshino M, Matsui N
Tokyo Metropolitan Tama Geriatric Hospital, Japan.
Nihon Jinzo Gakkai Shi. 1991 Jun;33(6):605-13.
Ten uremic patients maintained stable on regular dialysis treatment participated in a comparison study of 2 hours' biofiltration and 4 hours' bicarbonate hemodialysis with informed consents. In biofiltration, ultrafiltrate was replaced by a solution consisting of Na 145 mEq/l, HCO3- 100 and Cl 45 at the infusion rate 2.51/hour. Dialysate composition was Na 130-149 mEq/l, K 1.0, Cl 119, Ca 2.5, Mg 0.5, CH3COO- 15 and glucose 200 mg/dl. Hemodiafilter was F80, polysulphone, 1.9 m2, manufactured by Fresenius Co. Ltd. Blood flow rate was 5 ml/min/kg.body.weight to keep urea index (Kt/V) over 1.0. B-A-B' comparison was designed in which B and B' stand for 4 hours' bicarbonate hemodialysis while A for 2 hours' biofiltration, 3 times per week for 2 months, respectively. It was intended to find out if there are aggravations of clinical parameters in A after B and/or improvements in B' after A in view of evaluation of optimum for 2 hours' biofiltration. One patient was withdrawn from biofiltration at 15th treatment in A because of frequent muscular twitchings. Others finished the whole program, thus making drop-out rate 10%. No significant differences were observed in the following parameters between B and A and between A and B': cardiothoratic ratio, pre-treatment blood pressure, human atrial natriuretic hormone, cardiovascular dynamics, total protein, BUN, serum creatinine, uric acid, beta 2 microglobulin, blood counts, blood gas analysis, electrolytes, alkaline-phosphatase, PTH-C, protein catabolic rate (PCR), lipids and liver functions.(ABSTRACT TRUNCATED AT 250 WORDS)
十名接受常规透析治疗且病情稳定的尿毒症患者在签署知情同意书后参与了一项2小时生物滤过与4小时碳酸氢盐血液透析的对比研究。在生物滤过过程中,超滤液被一种由每升含145毫当量钠、100毫当量碳酸氢根和45毫当量氯组成的溶液替代,输注速率为每小时2.5升。透析液成分包括每升含130 - 149毫当量钠、1.0毫当量钾、119毫当量氯、2.5毫当量钙、0.5毫当量镁、15毫当量醋酸根和200毫克葡萄糖。血液滤过器为费森尤斯有限公司生产的F80聚砜材质、面积1.9平方米的产品。血流速率为每分钟每千克体重5毫升,以使尿素清除指数(Kt/V)超过1.0。研究采用B - A - B'对比设计,其中B和B'代表4小时碳酸氢盐血液透析,A代表2小时生物滤过,每周进行3次,共2个月。旨在从评估2小时生物滤过的最佳效果角度,探究在B之后A的临床参数是否恶化以及在A之后B'是否改善。一名患者在A组第15次治疗时因频繁肌肉抽搐退出生物滤过。其他患者完成了整个项目,因此脱落率为10%。在以下参数方面,B与A之间以及A与B'之间未观察到显著差异:心胸比率、治疗前血压、人心房利钠肽、心血管动力学、总蛋白、尿素氮、血清肌酐、尿酸、β2微球蛋白、血细胞计数、血气分析、电解质、碱性磷酸酶、甲状旁腺激素 - C、蛋白质分解代谢率(PCR)、血脂和肝功能。(摘要截选至250词)