Department of Nephrology, Chi-Mei Medical Center, Taiwan.
Ren Fail. 2010 Jan;32(2):185-91. doi: 10.3109/08860220903541127.
Few studies mention how to objectively adjust peritoneal dialysis (PD) dwell volume for adult continuous ambulatory peritoneal dialysis (CAPD) patients. We proposed a reference equation composed of parameters from the peritoneal equilibrium test (PET) for adjusting daily dialysate dwell volume to obtain more ultrafiltration volume. Better fluid control could reduce more fluid overload-related complications.
We used body mass index, waist circumference, intraperitoneal pressure, and other parameters from peritoneal equilibrium test to compose a reference equation for fine-tuning daily dwell volume.
Eighty-eight PD patients in one center with laboratory data collected during half-yearly PET evaluations were enrolled. Instilled dialysate was composed of 2.57% glucose PD fluid, either 1500 ml or 2000 ml in volume. In addition to other demographic data, intraperitoneal pressure (IPP) was also measured twice in the supine position four hours apart. We applied statistical multivariate techniques of discrimination analysis and logistic regression to verify the most feasible and optimal formula to determine infill volumes for patients.
We determined a novel formula for calculating daily dialysate dwell volume, Z: Z = (0.523 x waist circumference) + (0.852 x body mass index), derived from rotating axes to obtain an accurate prediction rate of 80.68% using the multivariate approach.
The novel formula used objective, real-time parameters for determining appropriate dwell volumes for PD patients to optimize maximal ultrafiltration volumes and reduce subjective abdominal discomfort. The novel formula makes frequent adjustment of daily dwell volume by physicians or patients easy to calculate.
很少有研究提到如何客观地调整成人持续非卧床腹膜透析（CAPD）患者的腹膜透析（PD）留置量。我们提出了一个参考方程，该方程由腹膜平衡试验（PET）中的参数组成，用于调整每日透析液留置量以获得更多超滤量。更好的液体控制可以减少更多与液体超负荷相关的并发症。
我们使用体重指数、腰围、腹腔内压力等腹膜平衡试验参数，组成一个参考方程，用于微调每日留置量。
我们招募了一家中心的 88 名 PD 患者，这些患者在半年一次的 PET 评估期间收集了实验室数据。注入的透析液由 2.57%葡萄糖 PD 液组成，体积为 1500 毫升或 2000 毫升。除了其他人口统计学数据外，还在相隔四小时的仰卧位两次测量腹腔内压力（IPP）。我们应用判别分析和逻辑回归等统计多元技术来验证确定患者填充量的最可行和最佳公式。
我们确定了一种新的公式来计算每日透析液留置量 Z：Z =（0.523 x 腰围）+（0.852 x 体重指数），通过旋转轴获得了 80.68%的准确预测率。
新公式使用客观、实时的参数来确定 PD 患者的适当留置量，以优化最大超滤量并减少主观腹部不适。新公式使医生或患者更容易计算每日留置量的频繁调整。
