Gotch F A, Sargent J A
Kidney Int Suppl. 1978 Jun(8):S108-11.
A theoretical definition of "minimal acceptable dialysis therapy" is that which: provides optimal sodium, potassium, hydrogen, and water homeostasis, optimal calcium and phosphorus homeostasis, and nontoxic concentration profiles for all other solutes which exhibit concentration-dependent toxicity normally controlled by renal excretion; results in maximal patient well-being and rehabilitation with minimal dialysis related morbidity; is sufficiently well-defined with respect to dose to be reliably prescribed for any individual patient which requires that, for all solutes of clinical importance, the kinetic behavior and closure of mass balance be verified for individual patients. Empirically, the minimum dose of dialysis (dialyzer urea clearance, treatment time and frequency) sufficient to result in mean predialysis BUN values of 80 mg/dl with documented dietary protein intake (DPI) greater than or equal to 1.0 g/kg/day and measured protein catabolic rate (PCR) equal to DPI has been shown to be acceptable with respect to currently achieved clinical outcome parameters.
“最小可接受透析治疗”的理论定义是：能实现钠、钾、氢和水平衡的最佳状态，钙和磷平衡的最佳状态，以及对所有其他通常由肾脏排泄控制浓度依赖性毒性的溶质保持无毒浓度分布；以最小的透析相关发病率实现患者最大程度的健康和康复；在剂量方面有足够明确的定义，以便能为任何需要透析的个体患者可靠地开出处方，这要求对于所有具有临床重要性的溶质，要验证个体患者的动力学行为和质量平衡的闭合情况。根据经验，对于记录的饮食蛋白摄入量（DPI）大于或等于1.0 g/kg/天且测量的蛋白分解代谢率（PCR）等于DPI的患者，足以使透析前平均血尿素氮（BUN）值达到80 mg/dl的最小透析剂量（透析器尿素清除率、治疗时间和频率），就目前所达到的临床结果参数而言已被证明是可接受的。
