Teixidó J, Cofan F, Borrás M, Bonet J, Bonal J, Galimany R, Biosca C, Caralps A
Nephrology Service, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Perit Dial Int. 1993;13 Suppl 2:S47-9.
The mass transfer area coefficient (MTC) is the best parameter for solute transport evaluation in continuous ambulatory peritoneal dialysis (CAPD) patients. We compared three simplified MTC methods (calculated according Garred, Krediet, or Lindholm) and the peritoneal equilibration test (PET) (Twardowski) to complex MTC (MTCX) (Randerson and Farrell) for urea and creatinine, by means of 29 tests performed in 24 stable CAPD patients. There were no significant differences (paired t-test) between MTCX and each of the simplified MTC, except for creatinine MTC calculated by Krediet's method, which was significantly different (MTCX: 9.36 +/- 4.32, K-MTC: 10.48 +/- 4.55, p < 0.05). Likewise, there was an acceptable correlation between complex MTC and each of the simplified methods including the PET. However, a more detailed study of the MTC's categorizations shows poor agreement with complex MTC categorization. Better results are obtained by PET categorization, which reaches good likelihood ratios either for positive or negative events. We conclude that simplified MTC or the dialysate/plasma ratio at 240 minutes for urea and creatinine has an acceptable correlation with complex MTC and can be useful in clinical practice. There is poor agreement between solute transport categorizations of simplified MTC and complex MTC. There is a better coincidence between the PET (D/P at 240 minutes) and complex MTC categorizations.
传质面积系数(MTC)是评估持续性非卧床腹膜透析(CAPD)患者溶质转运的最佳参数。我们通过对24例稳定的CAPD患者进行29次检测,比较了三种简化的MTC方法(根据Garred、Krediet或Lindholm计算)以及腹膜平衡试验(PET)(Twardowski法)与复杂MTC(MTCX)(Randerson和Farrell法)对尿素和肌酐的检测结果。除了用Krediet法计算的肌酐MTC有显著差异外(MTCX:9.36±4.32,K-MTC:10.48±4.55,p<0.05),MTCX与每种简化的MTC之间均无显著差异(配对t检验)。同样,复杂MTC与包括PET在内的每种简化方法之间都存在可接受的相关性。然而,对MTC分类的更详细研究表明,其与复杂MTC分类的一致性较差。PET分类能取得更好的结果,无论是阳性还是阴性事件,其似然比都很高。我们得出结论,简化的MTC或240分钟时尿素和肌酐的透析液/血浆比值与复杂MTC具有可接受的相关性,在临床实践中可能有用。简化MTC和复杂MTC的溶质转运分类之间一致性较差。PET(240分钟时的D/P)与复杂MTC分类之间的一致性更好。