el Akrout M, Jadoul M
Cliniques universitaires St-Luc, Service de néphrologie, Bruxelles.
Nephrologie. 1995;16(6):413-8.
The determination of the perdialytic urea reduction ratio (URR) allows the quantification of the dialysis dosage actually delivered to patients. We studied the influence of the timing of the post-dialysis blood sampling on the URR, the reproducibility of URR and the practical steps to be taken to improve our patients' URR. URR (n = 31) is higher when blood sampling is performed before (62.4 +/- 4%) than after restitution of the blood circuit, either at the arterial (61 +/- 4.2%, p < .0001) or venous needle (60.7 +/- 4.2%, p < .50). Once blood sampling modalities are standardized in clinically stable patients with unchanged dialysis technique, URR proves highly reproducible (variation coefficient 2.4 +/- 1.2% of URR). To improve URR in 29 patients, blood flow (n = 20) and/or dialyzer surface (n = 14) were increased. In 3 patients HD session duration was increased. Altogether, the mean URR in these 29 patients rises from 57.1 +/- 3.8% to 63.4 +/- 4.3% (p < .0001). In conclusion, URR is influenced by the modalities of post-dialysis blood sampling. URR is reproducible in clinically stable patients with unchanged dialysis technique. URR was significantly improved in our patients by adaptations of HD technique (mainly blood flow and dialyzer surface).
透析期间尿素清除率（URR）的测定可对实际给予患者的透析剂量进行量化。我们研究了透析后采血时间对URR的影响、URR的可重复性以及为提高我们患者的URR而应采取的实际措施。当在恢复血液回路之前进行采血时，URR（n = 31）更高（62.4 +/- 4%），而在动脉端（61 +/- 4.2%，p <.0001）或静脉端采血时（60.7 +/- 4.2%，p <.50）则较低。在透析技术不变的临床稳定患者中，一旦采血方式标准化，URR被证明具有高度可重复性（变异系数为URR的2.4 +/- 1.2%）。为提高29例患者的URR，增加了血流量（n = 20）和/或透析器表面积（n = 14）。3例患者延长了血液透析治疗时间。总之，这29例患者的平均URR从57.1 +/- 3.8%提高到63.4 +/- 4.3%（p <.0001）。总之，URR受透析后采血方式的影响。在透析技术不变的临床稳定患者中，URR具有可重复性。通过调整血液透析技术（主要是血流量和透析器表面积），我们患者的URR得到了显著改善。
