Clark W R, Mueller B A, Kraus M A, Macias W L
Renal Division, Baxter Healthcare Corp., McGaw Park, IL 60085, USA.
Nephrol Dial Transplant. 1998;13 Suppl 6:86-90. doi: 10.1093/ndt/13.suppl_6.86.
Recent results suggest that RRT delivery affects outcome in critically ill ARF patients. These data have generated interest in the use of RRT quantification methods, originally developed for ESRD patients, in ARF. However, the fundamental differences between ARF and ESRD, with respect to both patient and therapy characteristics, must be fully appreciated before making this extrapolation. These differences may render many of the simplified ESRD quantification formulae of little use in ARF. As is the case in ESRD, the use of clearance-based methods to compare disparate therapies is problematic in ARF. Although the optimal technique for RRT quantification in ARF remains to be defined, dialysate-side quantification may be the most rational approach for the future, as has been suggested for ESRD patients [43].
近期结果表明,肾脏替代治疗(RRT)的实施会影响急性肾衰竭(ARF)危重症患者的预后。这些数据引发了人们对于将最初为终末期肾病(ESRD)患者开发的RRT量化方法应用于ARF的兴趣。然而,在进行这种推断之前,必须充分认识到ARF和ESRD在患者及治疗特征方面的根本差异。这些差异可能导致许多简化的ESRD量化公式在ARF中用处不大。与ESRD的情况一样,在ARF中使用基于清除率的方法来比较不同的治疗方法存在问题。尽管ARF中RRT量化的最佳技术仍有待确定,但正如针对ESRD患者所建议的那样[43],透析液侧量化可能是未来最合理的方法。