Shinzato T, Nakai S, Fujita Y, Takai I, Morita H, Nakane K, Maeda K
Department of Internal Medicine, Branch Hospital, Nagoya University School of Medicine, Japan.
Nephron. 1994;67(3):280-90. doi: 10.1159/000187980.
We developed a new urea kinetic method for simultaneous determination of the Kt/V and protein catabolic rate (PCR) only from blood urea nitrogen (BUN) concentrations before and after a single dialysis session. Using this method, the parameters were calculated within 1.5 s even when a hand-held computer with a low central processing capacity is used. The total amount of urea eliminated during three dialysis sessions in 1 week is assumed to be equal to urea volume (Gw) generated over a 1-week period (Tw): [formula: see text]. Here, G is the generation rate, K is the dialyzer urea clearance, T is the dialysis time and C1, C2 and C3 are BUN during the respective dialysis session. If this equation and the equation expressing the urea kinetics during a single dialysis session are solved together, we have a solution for Kt/V and G. The thus-obtained Kt/V and G are corrected using the change in body weight. The corrected Kt/V showed a good correspondence with the parameter calculated with the classical method, and the midweek PCR derived from G determined by the present method being equivalent to the PCR averaged for a 1-week period determined by the classical methods.
我们开发了一种新的尿素动力学方法,仅根据单次透析前后的血尿素氮(BUN)浓度同时测定Kt/V和蛋白质分解代谢率(PCR)。使用该方法,即使使用中央处理能力较低的手持计算机,也能在1.5秒内计算出参数。假设1周内3次透析过程中清除的尿素总量等于1周时间(Tw)内产生的尿素容积(Gw):[公式:见原文]。这里,G是生成速率,K是透析器尿素清除率,T是透析时间,C1、C2和C3分别是各次透析过程中的BUN。如果将此方程与表示单次透析过程中尿素动力学的方程联立求解,就能得到Kt/V和G的解。如此得到的Kt/V和G会根据体重变化进行校正。校正后的Kt/V与用经典方法计算的参数具有良好的一致性,并且通过本方法由G得出的周中PCR与经典方法测定的1周平均PCR相当。