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慢性血液透析患者肾脏大小的超声测量:与残余肾功能的相关性

Sonographic measurement of renal size in patients undergoing chronic hemodialysis: Correlation with residual renal function.

作者信息

Zhang Wu-Xing, Zhang Zhi-Min, Cao Bing-Sheng, Zhou Wei

机构信息

Department of Nephrology, PLA Center of Transplantation, PLA 309th Hospital, Beijing 100091, P.R. China.

Department of Ultrasound, PLA 309th Hospital, Beijing 100091, P.R. China.

出版信息

Exp Ther Med. 2014 May;7(5):1259-1264. doi: 10.3892/etm.2014.1560. Epub 2014 Feb 19.

Abstract

Previous studies have reported that renal size may change when the function is compromised. However, it is not known whether sonographically measured renal size reflects the residual renal function (RRF) in patients undergoing chronic hemodialysis. A total of 140 patients undergoing chronic hemodialysis (≥3 months) were investigated in the present study. The patients were divided into two groups according to the daily urine volume: Individuals with RRF (RRF+ group; ≥200 ml; n=65) and without RRF (RRF- group; <200 ml; n=75). Renal sizes were measured using sonography and renal volumes were calculated with the ellipsoid formula. Univariable and multivariable stepwise forward logistic regression analyses were performed to examine the correlation between the presence of RRF and various variables. The results indicated that there were statistically significant differences (P<0.001) between the RRF+ and RRF- groups with regard to renal length, width, thickness and volume of the left (length, 7.9±1.2 vs. 6.8±1.2 cm; volume, 60.0±26.7 vs. 40.2±18.1 ml, respectively) and right (length, 7.6±1.2 vs. 6.7±1.2 cm; volume, 50.2±26.5 vs. 33.9±15.3 ml, respectively) sides of the kidney. Multivariable stepwise forward logistic regression analyses showed that the mean renal length or volume and hemodialysis duration were independent predictors of the presence of RRF. Therefore, renal size assessment by ultrasonography may be useful for RRF evaluation in patients undergoing chronic hemodialysis.

摘要

以往研究报道,肾功能受损时肾脏大小可能会改变。然而,对于接受慢性血液透析的患者,超声测量的肾脏大小是否反映残余肾功能(RRF)尚不清楚。本研究共纳入140例接受慢性血液透析(≥3个月)的患者。根据每日尿量将患者分为两组:有RRF的个体(RRF+组;≥200 ml;n=65)和无RRF的个体(RRF-组;<200 ml;n=75)。采用超声测量肾脏大小,并根据椭圆公式计算肾脏体积。进行单变量和多变量逐步向前逻辑回归分析以检验RRF的存在与各种变量之间的相关性。结果表明,RRF+组和RRF-组在左肾(长度,7.9±1.2 vs. 6.8±1.2 cm;体积,60.0±26.7 vs. 40.2±18.1 ml)和右肾(长度,7.6±1.2 vs. 6.7±1.2 cm;体积,50.2±26.5 vs. 33.9±15.3 ml)的长度、宽度、厚度和体积方面存在统计学显著差异(P<0.001)。多变量逐步向前逻辑回归分析表明,平均肾脏长度或体积以及血液透析持续时间是RRF存在的独立预测因素。因此,超声评估肾脏大小可能有助于评估接受慢性血液透析患者的RRF。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efb8/3991538/6dadad862098/ETM-07-05-1259-g00.jpg

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