Lopot F
University Hospital 2, Department of Internal Medicine, Praha, Strahov, Czechoslovakia.
Nephrol Dial Transplant. 1991;6 Suppl 3:86-7.
High-flux dialysers are frequently used for highly efficient ultrashort treatment schedules. To avoid the risk of inadequately low dialysis dose in this treatment strategy where 'every minute counts', it is often advocated to monitor the treatment quality by means of urea kinetic modelling (UKM). However, careful computational analysis of concentration curves generated by UKM versus more realistic two-pool model curves indicates the risk of substantial overestimation of the protein catabolic rate (PCR). Therefore conventional UKM should not be used to monitor and/or guide treatment schedules with dialyser urea clearance greater than 250 ml/min and dialysis time less than 3 h. Under these conditions, PCR can be overestimated by as much as 20%.
高通量透析器常用于高效的超短治疗方案。在这种“分秒必争”的治疗策略中，为避免透析剂量过低的风险，人们常主张通过尿素动力学建模（UKM）来监测治疗质量。然而，对UKM生成的浓度曲线与更符合实际的双池模型曲线进行仔细的计算分析表明，存在蛋白质分解代谢率（PCR）被大幅高估的风险。因此，当透析器尿素清除率大于250 ml/分钟且透析时间小于3小时时，不应使用传统UKM来监测和/或指导治疗方案。在这些情况下，PCR可能被高估多达20%。
