Lutes R, Holley J L, Perlmutter J, Piraino B
Renal-Electrolyte Division, University of Pittsburgh, Pennsylvania.
Adv Perit Dial. 1993;9:97-100.
We collected data on 43 stable peritoneal dialysis patients (60 values), all of whom had residual renal function, to determine the dependency of normalized protein catabolic rate (PCRN) on residual renal function as well as dialysis adequacy. All patients were on a stable peritoneal dialysis regimen for at least 4 months (median 8 months, range 4-64 months) and were without peritonitis or other serious infections for at least 6 months prior to data collection. Dialysate creatinine clearance (Ccr) was obtained from 24-hour collections of dialysate. Residual renal function was calculated from the average of the urea and the creatinine clearance from 24-hour urine collections. The normalized protein catabolic rate was calculated using the Randerson method. Using linear regression analysis, PCRN correlated with total weekly Ccr (r = 0.7, p < 0.0005), KT/V urea (r = 0.5, p < 0.0005), and residual renal function (r = 0.6, p < 0.0005). All patients with residual renal function more than 40 L/week had a PCRN greater than 1.0 g/kg/day. To assure a PCRN of 1.0 g/kg/day in all patients, a weekly KT/V urea of 1.9 and/or a total weekly Ccr of 79 L was required. These results confirm the important role of residual renal function in dialysis adequacy and elucidates its contribution to the maintenance of the patient's protein intake.
我们收集了43例稳定的腹膜透析患者（共60个数据）的数据，所有患者均有残余肾功能，以确定标准化蛋白分解代谢率（PCRN）对残余肾功能以及透析充分性的依赖性。所有患者均接受稳定的腹膜透析治疗至少4个月（中位数8个月，范围4 - 64个月），且在数据收集前至少6个月无腹膜炎或其他严重感染。透析液肌酐清除率（Ccr）通过收集24小时透析液获得。残余肾功能根据24小时尿液收集的尿素和肌酐清除率平均值计算。标准化蛋白分解代谢率采用Randerson方法计算。通过线性回归分析，PCRN与每周总Ccr（r = 0.7，p < 0.0005）、尿素KT/V（r = 0.5，p < 0.0005）和残余肾功能（r = 0.6，p < 0.0005）相关。所有残余肾功能超过40L/周的患者PCRN大于1.0g/kg/天。为确保所有患者的PCRN达到1.0g/kg/天，需要每周尿素KT/V为1.9和/或每周总Ccr为79L。这些结果证实了残余肾功能在透析充分性中的重要作用，并阐明了其对维持患者蛋白质摄入量的贡献。
