Department of Nephrology and Hypertension, University of California, Irvine, Orange, CA, USA.
Medicine/Nephrology, University of Illinois at Chicago, Burr Ridge, IL, USA.
Nephrol Dial Transplant. 2018 Mar 1;33(3):530-539. doi: 10.1093/ndt/gfw473.
The purpose of the study was to explore the precision of an equation designed to estimate residual kidney urea clearance (KRU) from interdialytic urine collection data and pre-hemodialysis (HD) serum urea nitrogen (SUN) in different hemodialysis treatment schedules.
The generalizability of the proposed equation was tested in 32 731 HD treatments where urine was collected prior to a dialysis session, mostly for 24 h but sometimes longer, in patients being dialyzed 1-4 times/week.
The residual kidney urea clearance estimating equation predicted a KRU that matched the one computed by formal modeling within 5% in >98% of sessions analyzed. The errors in estimated versus modeled KRU for interdialytic intervals (IDIs) of 2, 3, 4 and 7 days, were 1.6 ± 1.5%, -0.4 ± 1.6%, 0.9 ± 1.6%, and 1.5 ± 1.2%, respectively. Percent errors were similar for schedules of 1-4/week with the exception of urine collection during the 2-day interval of a 2:5-day twice-weekly schedule; here error averaged 5.0 ± 1.2%. Use of the average of the SUN values at the start and end of the collection period overestimated modeled KRU by 11.3 ± 4.5%, whereas an equation suggested by others underestimated modeled KRU by -9.9 ± 3.4%.
The equation tested predicts values for KRU that are similar to those obtained from formal urea kinetic modeling, with percent errors that only rarely exceed 5%. It gives relatively precise results for a wide range of HD treatment schedules, IDIs and urine collection periods.
chronic hemodialysis, clearance, guidelines, hemodialysis, predialysis.
本研究旨在探讨一种基于透析间期尿液收集数据和透析前血清尿素氮（SUN）估算残余肾尿素清除率（KRU）的方程在不同血液透析治疗方案中的精确性。
该方程的通用性在 32731 例血液透析治疗中进行了测试，这些治疗均在透析前收集尿液，收集时间大多为 24 小时，但有时更长，患者每周透析 1-4 次。
在分析的大多数治疗中，估算的 KRU 与通过正式模型计算得出的 KRU 相差在 5%以内，占比超过 98%。对于 2、3、4 和 7 天的透析间期（IDIs），估算的 KRU 与模型计算的 KRU 之间的误差分别为 1.6±1.5%、-0.4±1.6%、0.9±1.6%和 1.5±1.2%。对于每周 1-4 次的透析方案，误差百分比相似，但对于每周透析 2 次、2:5 天方案的 2 天 IDI 期间，误差平均为 5.0±1.2%。使用收集期开始和结束时 SUN 值的平均值会使模型计算的 KRU 高估 11.3±4.5%，而其他人提出的方程则会使模型计算的 KRU 低估-9.9±3.4%。
该测试方程预测的 KRU 值与通过正式尿素动力学模型获得的值相似，误差百分比很少超过 5%。它为广泛的血液透析治疗方案、IDIs 和尿液收集期提供了相对精确的结果。
慢性血液透析；清除率；指南；血液透析；透析前。
