Albouze G, Yanai M, Calamai M, Testou D, Jungers P, Man N K
Chateauroux Dialysis Center, INSERM U 90 Necker Hospital, Paris, France.
Kidney Int Suppl. 1993 Jun;41:S278-81.
Kt/V-urea and protein catabolic rate (PCR) are used for dialysis prescription and evaluation of protein intake of patients on regular dialysis treatment. The study was undertaken to determine the implication of urea rebound and residual renal function (RRF) on the calculation of Kt/V-urea and PCR for 61 patients. Kt/V-urea and PCR were calculated, implementing or not urea rebound at one hour after the end of dialysis session. Urea and creatinine rebound rate in patients without RRF was significantly higher than in patients with RRF (P < 0.05). In patients without RRF, creatinine generation rate and Kt/V-urea calculated without rebound were significantly higher than calculated with rebound (P < 0.001). On the contrary, calculation of urea generation and PCR is not affected by these parameters. It is concluded that: (1) Rebound rate magnitude of urea and creatinine is dependent on solute molecular weight, RRF and probably on dialysis duration, whereas rebound rate magnitude of phosphorus is not affected, and (2) Rebound should be taken into account in the calculation of Kt/V-urea and creatinine generation rate in patients without RRF, otherwise, they would be overestimated.
尿素清除率（Kt/V）和蛋白质分解代谢率（PCR）用于透析处方制定以及评估规律透析治疗患者的蛋白质摄入量。本研究旨在确定61例患者中尿素反弹和残余肾功能（RRF）对尿素清除率（Kt/V）及PCR计算的影响。在透析结束1小时后计算尿素清除率（Kt/V）和PCR，计算时考虑或不考虑尿素反弹情况。无残余肾功能患者的尿素和肌酐反弹率显著高于有残余肾功能患者（P<0.05）。在无残余肾功能患者中，未考虑反弹计算的肌酐生成率和尿素清除率（Kt/V）显著高于考虑反弹计算的值（P<0.001）。相反，尿素生成及PCR的计算不受这些参数影响。研究得出结论：（1）尿素和肌酐的反弹率大小取决于溶质分子量、残余肾功能，可能还与透析时长有关，而磷的反弹率大小不受影响；（2）在计算无残余肾功能患者的尿素清除率（Kt/V）和肌酐生成率时应考虑反弹情况，否则会高估这些指标。
