Rodríguez-Carmona A, Selgas R, Martínez M E, Ortí F, Miguel J L, Salinas M, Riñón C, Sánchez-Sicilia L
Nephron. 1984;37(1):21-4. doi: 10.1159/000183201.
Recent studies have shown that the mass transfer coefficients (MTC) for low- and middle-molecular-weight substances are maintained at medium terms in patients under continuous ambulatory peritoneal dialysis (CAPD) therapy. We have studied the MTC for parathormone (MW 5,500-6,000) in 29 patients under CAPD. 11 patients were assessed once, 9 patients were assessed twice, and 9 were assessed three times, with 6-month intervals between assessments; in 15 cases nitroprusside (4.5 mg/l) was added to the dialysate, and in 2 cases the assessment was carried out during an episode of peritonitis. A bicompartmental model with exponential ultrafiltration was used, and the generation rates were calculated by mass balance. The MTC was calculated by minimization of the quadratic error, following the procedure of Runge and Kutta. The mean MTC values were 21.2 +/- 5.9 for urea, 10.26 +/- 5.9 for creatinine 2.8 +/- 1.8 for inulin and 1.0 +/- 0.8 for parathormone (PTH), with significant correlation between the MTC values for PTH and inulin (r = 0.5, p less than 0.01). There is a direct correlation between MTCPTH and peritoneal PTH clearance, and an inverse one between MTCPTH and serum PTH, with r = 0.8 and 0.51, respectively. No correlation was found between the MTC for inulin or PTH and the duration of the CAPD therapy, nor with the number of episodes of peritonitis. No significant medium-term variations were detected in the MTC values for PTH and inulin. Both peritonitis and the intraperitoneal administration of nitroprusside induce significant increases in the MTCPTH.
近期研究表明，在持续性非卧床腹膜透析（CAPD）治疗的患者中，低分子量和中分子量物质的传质系数（MTC）在中期保持稳定。我们研究了29例接受CAPD治疗患者的甲状旁腺激素（分子量5500 - 6000）的MTC。11例患者接受了一次评估，9例患者接受了两次评估，9例患者接受了三次评估，评估间隔为6个月；15例患者的透析液中添加了硝普钠（4.5 mg/l），2例患者在腹膜炎发作期间进行了评估。采用具有指数超滤的双室模型，并通过质量平衡计算生成率。按照龙格 - 库塔方法，通过最小化二次误差来计算MTC。尿素的平均MTC值为21.2±5.9，肌酐为10.26±5.9，菊粉为2.8±1.8，甲状旁腺激素（PTH）为1.0±0.8，PTH和菊粉的MTC值之间存在显著相关性（r = 0.5，p＜0.01）。MTCPTH与腹膜PTH清除率呈正相关，与血清PTH呈负相关，r分别为0.8和0.51。未发现菊粉或PTH的MTC与CAPD治疗持续时间以及腹膜炎发作次数之间存在相关性。未检测到PTH和菊粉的MTC值有明显的中期变化。腹膜炎和腹腔内给予硝普钠均导致MTCPTH显著增加。
