Navarro J F, del Castillo N, Fernández J L, Macía M L, Méndez M L, Chahin J, García-Nieto V, Gallego E, Mora-Fernández C, García J
Department of Nephrology, Hospital Ntra. Sra. de Candelaria, S/C de Tenerife, Canary Islands, Spain.
Artif Organs. 1997 Feb;21(2):91-5. doi: 10.1111/j.1525-1594.1997.tb00343.x.
To date, the magnitude, causes, and factors that govern urea rebound are not clearly defined. This study was undertaken to determine the possible influence of the biocompatibility of dialyzer membrane on urea rebound and to assess the participation of rebound in the calculation of Kt/V-urea by different methods. Blood urea samples were obtained before, and at 2, 30, and 60 min posthemodialysis in 8 patients undergoing dialysis with 2 different membranes, Cuprophan and polyacrylonitrile (24 sessions with each membrane). Urea rebound was documented in all patients. The degree of rebound was large, 20%, and it was achieved within 30 min after the end of dialysis. Urea rebound was observed with both Cuprophan and polyacrylonitrile membranes, without significant differences. Kt/V-urea significantly decreased (p < 0.001) by all methods when urea rebound was incorporated. We conclude that urea rebound is clinically very important and is not influenced by the biocompatibility of the dialyzer membrane. This phenomenon must be taken into account in the calculation of Kt/V; otherwise, it might be overestimated.
迄今为止，尿素反跳的程度、原因及相关影响因素尚未明确界定。本研究旨在确定透析器膜生物相容性对尿素反跳的可能影响，并评估不同方法计算Kt/V-尿素时反跳的作用。对8例使用两种不同膜（铜仿膜和聚丙烯腈膜）进行透析的患者，在血液透析前、透析结束后2分钟、30分钟及60分钟采集血尿素样本（每种膜各进行24次透析）。所有患者均出现尿素反跳。反跳程度较大，为20%，且在透析结束后30分钟内即可出现。使用铜仿膜和聚丙烯腈膜均观察到尿素反跳，二者无显著差异。纳入尿素反跳后，所有方法计算的Kt/V-尿素均显著降低（p<0.001）。我们得出结论，尿素反跳在临床上非常重要，且不受透析器膜生物相容性的影响。在计算Kt/V时必须考虑这一现象；否则，可能会高估Kt/V。
