Kuno T, Man N K, Chauveau P, Poignet J L, Naret C, Takahashi S
Départment de Néphrologie, INSERM U90 Hôpital Necker, Paris, France.
Nihon Jinzo Gakkai Shi. 1990 Jul;32(7):809-16.
Effects of metabolic acidosis were compared between bicarbonate dialysis (BCD) and acetate-free biofiltration (AFB). Three stable dialysis patients (1M, 2F, mean age 30 yrs) were selected for the study because their bicarbonate (BC) pre-dialysis plasma concentration were always under 16 mmol/l while they were on 33 mmol/l-BCD thrice weekly for 12 months. They were switched to a 6 months period of AFB. Pre- and post-dialysis BC plasma concentration, other blood chemical parameters and mass removal (total collection of used dialysate) of urea (U), creatinine (Cr), uric acid (UA), and phosphate (P) were measured during the last week of each period, including 3 dialysis sessions. Mean calorie and protein intake were 29.4 KCal/kg.d and 1.5 g/Kg.d (BCD period) and 38.2 Kcal/Kg.d and 1.5 g/Kg.d (AFB period) respectively. BC plasma concentration (Mean +/- SE, mmol/l) at the pre and post-dialysis in AFB were significantly higher than those in BCD (16.6 +/- 0.7 vs 20.8 +/- 0.6; p less than 0.001, 22.7 +/- 0.8 vs 25.8 +/- 0.8; P less than 0.02). Pre- and post-dialysis U plasma concentration (Mean +/- SE, mmol/l) in AFB were significantly lower than those in BCD (34.3 +/- 2.51 vs 20.8 +/- 0.59, 10.5 +/- 1.32 vs 7.5 +/- 0.92; P less than 0.001). Pre-dialysis P plasma concentration (Mean +/- SE, mmol/l) in AFB was significantly lower than that in BCD (1.85 +/- 0.09 vs 1.50 +/- 0.15; P less than 0.01). Cr, UA and P mass removal in BCD and AFB were not significantly different. However, U mass removal in AFB was significantly lower than that in BCD.(ABSTRACT TRUNCATED AT 250 WORDS)
比较了碳酸氢盐透析(BCD)和无醋酸盐生物滤过(AFB)对代谢性酸中毒的影响。选择了3例稳定的透析患者(1例男性,2例女性,平均年龄30岁)进行研究,因为他们在每周3次、每次33 mmol/L的BCD治疗12个月期间,透析前血浆碳酸氢盐(BC)浓度始终低于16 mmol/L。之后他们转为接受6个月的AFB治疗。在每个治疗阶段的最后一周(包括3次透析治疗),测量透析前和透析后BC血浆浓度、其他血液化学参数以及尿素(U)、肌酐(Cr)、尿酸(UA)和磷酸盐(P)的清除量(用过的透析液总收集量)。平均热量和蛋白质摄入量在BCD阶段分别为29.4千卡/千克·天和1.5克/千克·天,在AFB阶段分别为38.2千卡/千克·天和1.5克/千克·天。AFB透析前和透析后的BC血浆浓度(平均值±标准误,mmol/L)显著高于BCD(16.6±0.7对20.8±0.6;p<0.001,22.7±0.8对25.8±0.8;P<0.02)。AFB透析前和透析后的U血浆浓度(平均值±标准误,mmol/L)显著低于BCD(34.3±2.51对20.8±0.59,10.5±1.32对7.5±0.92;P<0.001)。AFB透析前P血浆浓度(平均值±标准误,mmol/L)显著低于BCD(1.85±0.09对1.50±0.15;P<0.01)。BCD和AFB中Cr、UA和P的清除量无显著差异。然而,AFB中U的清除量显著低于BCD。(摘要截选至250字)