Shestopalov A E, Kishkun A A, Belov V A, D'iakov S V
Anesteziol Reanimatol. 1989 Mar-Apr(2):56-9.
Changes in osmolarity, blood and urine levels of medium-size molecules (MSM), osmolarity and MSM index, free water clearance (FWC) and alterations in traditional clinical and biochemical parameters typical of acute renal failure (creatinine, urea nitrogen, K+, Na+, diuresis) have been compared in 27 patients with peritonitis complicated in 17 cases by acute renal failure (ARF). In patients with developing ARF disturbances in osmotic condition, osmotic clearance, FWC, MSM level precede an increase in creatinine and urea nitrogen level and diuresis decrease. Dynamic studies of FWC and MSM blood and urine levels allow of early ARF diagnosis in patients with peritonitis. Progressive growth of plasma osmolarity and FWC with a parallel decrease in MSM index below 1 is a criterion indicative of functional renal failure turning into organic one.
对27例患有腹膜炎且其中17例并发急性肾衰竭（ARF）的患者，比较了其渗透压、中分子物质（MSM）的血液和尿液水平、渗透压和MSM指数、自由水清除率（FWC）以及急性肾衰竭典型的传统临床和生化参数（肌酐、尿素氮、钾离子、钠离子、尿量）的变化。在发生ARF的患者中，渗透状态、渗透清除率、FWC、MSM水平的紊乱先于肌酐和尿素氮水平升高及尿量减少。对FWC以及MSM血液和尿液水平进行动态研究，有助于早期诊断腹膜炎患者的ARF。血浆渗透压和FWC进行性升高，同时MSM指数降至1以下，这是功能性肾衰竭转变为器质性肾衰竭的一个指征。
