Ding Linda, Johnston James, Pinsk Maury N
Department of Pediatrics and Child Health, University of Manitoba, Rady College of Medicine, Winnipeg, Manitoba, Canada.
Pediatr Nephrol. 2021 Aug;36(8):2265-2277. doi: 10.1007/s00467-020-04816-9. Epub 2021 Jan 5.
Dialysis adequacy for pediatric patients has largely followed the trends in adult dialysis by judging the success or adequacy of peritoneal or hemodialysis with urea kinetic modeling. While this provides a starting point to establish a dose of dialysis, it is clear that urea is only part of the picture. Many clinical parameters and interventions now have been identified that are just as impactful on mortality and morbidly as urea clearance. As such, our concept of adequacy is evolving to include non-urea parameters and assessing the impact that following an "adequate therapy" has on patient lives. As we move to a new era, we consider the impact these therapies have on patients and how it affects the quality of their lives; we must take these factors into consideration to achieve a therapy that is not just adequate, but livable.
儿科患者的透析充分性很大程度上遵循了成人透析的趋势，通过尿素动力学模型来判断腹膜透析或血液透析的成功与否或充分性。虽然这为确定透析剂量提供了一个起点，但很明显，尿素只是其中一部分。现在已经确定了许多临床参数和干预措施，它们对死亡率和发病率的影响与尿素清除率一样大。因此，我们对充分性的概念正在不断发展，以纳入非尿素参数，并评估遵循“充分治疗”对患者生活的影响。随着我们进入一个新时代，我们考虑这些治疗方法对患者的影响以及它如何影响他们的生活质量；我们必须考虑这些因素，以实现一种不仅充分而且可行的治疗方法。
