Rashid Humayun
Department of Nephrology, National Institute of Kidney Diseases, Sheikh Zayed Hospital, Lahore, Pakistan.
Saudi J Kidney Dis Transpl. 2015 Jul-Aug;26(4):692-6. doi: 10.4103/1319-2442.160130.
The objective of our study is to compare the C-reactive protein (CRP) levels with the delivered dose of dialysis in terms of Kt/V in patients undergoing maintenance hemodialysis (HD). This is a comparative, cross-sectional survey. The study was conducted at the HD unit of the Shaikh Zayed Hospital, Lahore, Pakistan. Patients who fulfilled the inclusion and exclusion criteria were enrolled in this study. The delivered dose of HD (Kt/V) was assessed by an online clearance module (OCM) in Fresenius machines at the end of every dialysis session and the weekly Kt/V was determined by adding all three Kt/V values. The serum CRP sample was taken after each session of HD and the mean CRP was calculated and considered elevated if it was >6 mg/dL. Both weekly Kt/V and CRP values were entered in a pre-designed proforma. Data were analyzed by using statistical software SPSS and P-value £0.05 was considered significant. Of 100 patients on maintenance HD, high serum CRP level (>6 mg/dL) was found in 38 patients. When the Kt/V was compared with the CRP level, there was a negative correlation between the two parameters (r = 0.212, P = 0.032). Low Kt/V means dialysis inadequacy, which is associated with chronic inflammatory state, resulting in high CRP levels. We suggest that the quality of life of dialysis patients can be improved by offering an adequate dose of HD reflected by Kt/V ≥3.6/week.
我们研究的目的是在接受维持性血液透析(HD)的患者中,比较C反应蛋白(CRP)水平与以Kt/V表示的透析剂量。这是一项比较性横断面调查。研究在巴基斯坦拉合尔谢赫扎耶德医院的血液透析科进行。符合纳入和排除标准的患者被纳入本研究。每次透析结束时,通过费森尤斯机器上的在线清除模块(OCM)评估HD的透析剂量(Kt/V),每周的Kt/V通过将三个Kt/V值相加来确定。每次HD治疗后采集血清CRP样本,计算平均CRP水平,若>6mg/dL则视为升高。每周的Kt/V和CRP值均录入预先设计的表格。使用统计软件SPSS进行数据分析,P值≤0.05被认为具有统计学意义。在100例维持性HD患者中,38例患者血清CRP水平较高(>6mg/dL)。当比较Kt/V与CRP水平时,这两个参数之间存在负相关(r = 0.212,P = 0.032)。低Kt/V意味着透析不充分,这与慢性炎症状态相关,导致CRP水平升高。我们建议,通过提供足够剂量的HD(以每周Kt/V≥3.6表示)可以改善透析患者的生活质量。