Division of Nephrology, Department of Medicine, Loyola University Chicago, Maywood, IL; Department of Public Health Sciences, Loyola University Chicago, Maywood, IL.
Division of Nephrology, Department of Medicine, Henry Ford Medical Center, Detroit, MI.
Am J Kidney Dis. 2016 Oct;68(4):522-532. doi: 10.1053/j.ajkd.2016.06.010. Epub 2016 Jul 19.
High hemodialysis ultrafiltration rate (UFR) is increasingly recognized as an important and modifiable risk factor for mortality among patients receiving maintenance hemodialysis. Recently, the Kidney Care Quality Alliance (KCQA) developed a UFR measure to assess dialysis unit care quality. The UFR measure was defined as UFR≥13mL/kg/h for patients with dialysis session length less than 240 minutes and was endorsed by the National Quality Forum as a quality measure in December 2015. Despite this, implementation of a UFR threshold remains controversial. In this NKF-KDOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) Controversies Report, we discuss the concept of the UFR, which is governed by patients' interdialytic weight gain, body weight, and dialysis treatment time. We also examine the potential benefits and pitfalls of adopting a UFR threshold as a clinical performance measure and outline several aspects of UFR thresholds that require further research.
高血液透析超滤率（UFR）越来越被认为是接受维持性血液透析患者死亡的一个重要且可改变的危险因素。最近，肾脏护理质量联盟（KCQA）制定了一个 UFR 测量指标来评估透析单位的护理质量。该 UFR 测量指标定义为透析时间少于 240 分钟的患者 UFR≥13mL/kg/h，该指标于 2015 年 12 月被国家质量论坛认可为质量指标。尽管如此，实施 UFR 阈值仍然存在争议。在这份 NKF-KDOQI（美国国家肾脏基金会-肾脏疾病预后质量倡议）争议报告中，我们讨论了 UFR 的概念，它由患者的透析间期体重增加、体重和透析治疗时间决定。我们还研究了采用 UFR 阈值作为临床绩效测量指标的潜在益处和陷阱，并概述了 UFR 阈值需要进一步研究的几个方面。
