Medical Engineering Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
Department of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Ther Apher Dial. 2024 Aug;28(4):505-510. doi: 10.1111/1744-9987.14117. Epub 2024 Mar 7.
Rheocarna's therapeutic effect is associated with fibrinogen (Fib) and low-density lipoprotein cholesterol (LDL-C) adsorptive removal. This study aimed to retrospectively investigate the association between treatment volume (TV) and circulating blood volume (CBV) and the Fib removal rate (Fib-RR) and LDL-C-RR.
CBV and TV/CBV, cut-off value (CO value), and area under the receiver operating characteristic (ROC) curve (AUC) were calculated. The Fib-RR and LDL-C-RR at the midterm and end of treatment were compared. The groups were further categorized into three groups with TV/CBV lower than or higher than the CO value at the midterm and end (midterm/end; Group L: lower than/lower than CO; Group L/H: lower than/higher than CO; Group H: higher than/higher than CO), and the Fib-RR and LDL-RR of each group at the midterm and end were compared.
ROC analysis revealed a TV of 1.480 times the BV as CO value, which showed a maximum Youden index predicting a Fib-RR of 20% (AUC: 0.828). Among the three groups, Group L and Group L/H demonstrated significantly higher Fib-RR and LDL-C-RR at the end of the study than in the midterm, while Group H exhibited no difference.
The results reveal that a treatment volume of 1.5 times the circulating blood volume is a sufficient solute removal capacity in the Rheocarna-enabled cases.
雷霍卡纳的治疗效果与纤维蛋白原(Fib)和低密度脂蛋白胆固醇(LDL-C)的吸附去除有关。本研究旨在回顾性调查治疗量(TV)和循环血量(CBV)与 Fib 去除率(Fib-RR)和 LDL-C-RR 的关系。
计算 CBV 和 TV/CBV、截止值(CO 值)和受试者工作特征曲线(ROC)下的面积(AUC)。比较治疗中期和结束时的 Fib-RR 和 LDL-C-RR。将这些组进一步分为治疗中期和结束时 TV/CBV 低于或高于 CO 值的三组(中期/结束;组 L:低于/低于 CO;组 L/H:低于/高于 CO;组 H:高于/高于 CO),并比较各组中期和结束时的 Fib-RR 和 LDL-RR。
ROC 分析显示,BV 的 1.480 倍 TV 为 CO 值,其预测 Fib-RR 为 20%时具有最大的 Youden 指数(AUC:0.828)。在三组中,组 L 和组 L/H 在研究结束时的 Fib-RR 和 LDL-C-RR 明显高于中期,而组 H 则没有差异。
结果表明,雷霍卡纳治疗病例中,治疗量达到循环血量的 1.5 倍即可达到足够的溶质去除能力。