Keshaviah P R, Hanson G L, Berkseth R O, Collins A J
Regional Kidney Disease Program, Hennepin County Medical Center, Minneapolis, Minnesota.
ASAIO Trans. 1988 Jul-Sep;34(3):620-2.
The urea kinetic model has been used to individualize therapy prescription. Because the urea kinetic model is complex, the modeling approach to therapy monitoring is not widely practiced. Presented here is a simplified approach to therapy prescription monitoring that is based on the full-fledged urea kinetic model. A Kt/V-PCR domain map (K: clearance, t: time and V: volume of urea distribution; PCR: protein catabolic rate) has been developed with the predialysis urea nitrogen concentration on the abscissa and the post/pre dialysis urea concentration ratio on the ordinate. On this domain map, the therapy index Kt/V is represented by a family of horizontal lines and the PCR is represented by a family of curved lines. In this simplified approach, mid-week measurements of the pre (C1) and post (C2) dialysis urea nitrogen concentrations are plotted on the domain map. The position of the plotted point allows one to read off the Kt/V index and the PCR to determine whether therapy index, diet, or both need to be modified.
尿素动力学模型已被用于个体化治疗方案的制定。由于尿素动力学模型较为复杂，基于该模型的治疗监测方法并未得到广泛应用。本文介绍一种基于成熟尿素动力学模型的简化治疗方案监测方法。已绘制出一张Kt/V-PCR区域图（K：清除率，t：时间，V：尿素分布容积；PCR：蛋白质分解代谢率），横坐标为透析前尿素氮浓度，纵坐标为透析后/透析前尿素浓度比值。在这张区域图上，治疗指标Kt/V由一系列水平线表示，PCR由一系列曲线表示。在这种简化方法中，将透析周中测量的透析前（C1）和透析后（C2）尿素氮浓度标绘在区域图上。标绘点的位置可使人们读出Kt/V指标和PCR，以确定是否需要调整治疗指标、饮食或两者均需调整。
