Ijelu G, Goldstein M, Raja R M
Albert Einstein Medical Center, Kraftsow Division of Nephrology, Department of Medicine, Philadelphia, Pennsylvania 19141.
ASAIO Trans. 1990 Jul-Sep;36(3):M152-4.
Analysis of the National Cooperative Dialysis Study (NCDS) showed that dialysis morbidity was related to Kt/V. Recently, various formulae have been shown to be accurate for easier calculation of Kt/V. We calculated Kt/V in an outpatient unit utilizing Kt/V = -In (R - 0.03 - UF/W) in 51 patients. Kt/V was less than 0.8 in 16 patients (Group A), 0.8-1.0 in 20 (Group B), and greater than 1.0 in 15 (Group C). There was no difference in hematocrit (Hct), BUN, creatinine, serum phosphorus, and albumin. Ratio of men to women was 11/5, 15/5, and 4/11; mean age was 54, 63, and 58 years; mean body weight 177, 144, and 122 lb in Groups A, B, and C, respectively. Dialysis-related hospital admissions were similar (p greater than 0.05). These data suggest patients with higher body weights, and men, frequently had a Kt/V less than 0.8. Kt/V that did not influence biochemical parameters or hospitalizations in this population. This indicates that Kt/V may not be a good predictor of morbidity, and/or some heavier patients may do fairly well even with a Kt/V less than 0.8. The search for a better index of dialysis adequacy should be continued.
对国家合作透析研究（NCDS）的分析表明，透析发病率与Kt/V相关。最近，各种公式已被证明可准确且更简便地计算Kt/V。我们在一个门诊单位对51例患者使用Kt/V = -In（R - 0.03 - UF/W）计算Kt/V。16例患者（A组）的Kt/V小于0.8，20例（B组）的Kt/V为0.8 - 1.0，15例（C组）的Kt/V大于1.0。血细胞比容（Hct）、血尿素氮（BUN）、肌酐、血清磷和白蛋白方面无差异。A、B、C组的男女比例分别为11/5、15/5和4/11；平均年龄分别为54岁、63岁和58岁；平均体重分别为177磅、144磅和122磅。与透析相关的住院情况相似（p大于0.05）。这些数据表明，体重较大的患者和男性，其Kt/V常小于0.8。在该人群中，Kt/V并未影响生化参数或住院情况。这表明Kt/V可能不是发病率的良好预测指标，和/或一些体重较重的患者即使Kt/V小于0.8也可能情况良好。应继续寻找更好的透析充分性指标。
