Bosticardo G M, Avalle U, Giacchino F, Molino A, Alloatti S
Ivrea Nephrology and Dialysis Units, Italy.
ASAIO J. 1994 Jul-Sep;40(3):M426-30. doi: 10.1097/00002480-199407000-00035.
To verify the accuracy of a urea monitor (UM) to assess dialysis adequacy, it was compared with a modified direct dialysis quantification method (mDDQ) and with a Casino modified urea kinetic model (mUKM) algorithm. Simplified Jindal and Daugirdas formulas, an anthropometric body water Watson formula, bioelectric impedance analysis, and the Garred model have also been considered. Concerning urea removal, UM results are close to mDDQ, as are the predialytic blood urea nitrogen values obtained by UM in the initial equilibration test. Urea distribution volume results for UM, mDDQ, and bioelectric impedance analysis are similar, whereas it appears clearly overestimated by the Watson formula. Urea monitor clearances are not significantly different from mDDQ, unlike UM Kt/V, which is slightly higher than mDDQ reference value, although with a satisfactory degree of concordance. Rebound effect must be considered by sampling after the equilibration time (et) when mUKM or simplified Kt/V formulas are used: mUKMet Kt/V results are quite similar to mDDQ, as is the Daugirdas value. Regarding NPCR, UM results are neither significantly different from mDDQ nor from the Garred model, whereas mUKM results are significantly overestimated. When rebound is considered, NPCR by mUKMet and NCPR by mDDQ are identical. The UM approach is simple and practical, with a satisfactory degree of reliability for clinical practice.
为验证尿素监测仪（UM）评估透析充分性的准确性，将其与改良直接透析定量法（mDDQ）及卡西欧改良尿素动力学模型（mUKM）算法进行比较。还考虑了简化的金达尔公式和道格拉斯公式、基于人体测量学的沃森体水公式、生物电阻抗分析以及加雷德模型。关于尿素清除，UM的结果与mDDQ接近，UM在初始平衡试验中获得的透析前血尿素氮值也是如此。UM、mDDQ和生物电阻抗分析的尿素分布容积结果相似，而沃森公式明显高估了该值。UM的尿素清除率与mDDQ无显著差异，与UM的Kt/V不同，后者略高于mDDQ参考值，不过一致性程度令人满意。当使用mUKM或简化的Kt/V公式时，在平衡时间（et）后采样必须考虑反弹效应：mUKMet Kt/V结果与mDDQ非常相似，道格拉斯值也是如此。关于标准化蛋白分解率（NPCR），UM的结果与mDDQ及加雷德模型均无显著差异，而mUKM的结果被明显高估。考虑反弹时，mUKMet的NPCR与mDDQ的NCPR相同。UM方法简单实用，在临床实践中具有令人满意的可靠性。
