Dunne Nina, Campbell Malcolm, Fitzpatrick Maggie, Callery Peter
University of Brighton, Sussex, UK.
J Ren Care. 2014 Jun;40(2):117-24. doi: 10.1111/jorc.12059. Epub 2014 Mar 20.
The National Kidney Foundation-Dialysis Outcomes Quality Initiative (KDOQI) guidelines and the Renal Association recommend the use of either Kt/V or urea reduction ratio (URR) to measure haemodialysis adequacy.
To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of single pool Kt/V (spKt/V) and URR.
A service evaluation was conducted to establish current practices in measuring dialysis adequacy. A prospective longitudinal study was conducted to compare spKt/V and URR.
Thirty-two children were recruited consisting of 13 males and 19 females in five paediatric dialysis centres.
Inconsistencies were reported of the method of post-urea sampling with 4 of the 10 centres using the KDOQI recommended sampling method. Five dialysis centres reported using URR and five reported using spKt/V. There were substantial differences between the two measures. Using URR suggested that up to 44% of children did not receive adequate dialysis, whereas measurement by spKt/V suggested no more than 6% of the same dialysis sessions were not adequate.
One standard measure should be used to assess dialysis adequacy in paediatric centres in England. KDOQI guidelines were not consistently followed in obtaining a post-urea blood sample and this procedure should be standardised.
美国国家肾脏基金会透析预后质量倡议（KDOQI）指南和英国肾脏协会建议使用Kt/V或尿素清除率（URR）来衡量血液透析充分性。
确定用于测量儿童血液透析充分性的方法，并评估单池Kt/V（spKt/V）和URR计算结果之间的一致性。
开展一项服务评估以确立测量透析充分性的现行做法。进行一项前瞻性纵向研究以比较spKt/V和URR。
在5个儿科透析中心招募了32名儿童，其中13名男性，19名女性。
报告了尿素采样后方法不一致的情况，10个中心中有4个使用KDOQI推荐的采样方法。5个透析中心报告使用URR，5个报告使用spKt/V。这两种测量方法之间存在显著差异。使用URR表明高达44%的儿童未接受充分透析，而通过spKt/V测量表明相同透析疗程中不充分的比例不超过6%。
英国的儿科中心应采用一种标准测量方法来评估透析充分性。在获取尿素后血样时未始终遵循KDOQI指南，该程序应标准化。
