کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
3885512 | 1249515 | 2006 | 6 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Reduction in urea distribution volume over time in clinically stable dialysis patients Reduction in urea distribution volume over time in clinically stable dialysis patients](/preview/png/3885512.png)
We have previously shown that, assuming urea distribution volume (V) remains constant for 1 month, ionic dialysance (ID) allows the dialysis dose to be calculated without the need for blood sampling. The aim of this multicenter study was to verify whether the assumption of a constant V can be extended to 1 year. In clinically stable patients receiving thrice-weekly hemodialysis at 13 dialysis centers, V and Kt/V were assessed during three dialysis sessions at baseline and 1 year later using ID as dialyzer urea clearance and the single-pool urea kinetic model. Baseline albumin, hemoglobin, and C reactive protein were prespecified covariates for predicting the change in V over time. Of the 52 enrolled patients, 40 (25 males; age 63.0±13.5 years) completed the study. Baseline end-dialysis body weight (62.4±13.7 kg) showed a non-significant 1% reduction during follow-up (-0.6±2.8 kg; P=0.175), whereas V significantly decreased from 29.0±6.8 to 27.4±6.0 l (-1.6±3.0 l or 4.5%; P=0.002). The reduction in V was greater when baseline albumin was lower (P=0.001) and baseline V was higher (P=0.005). The single-pool Kt/V calculated using baseline V underestimated the actual value by 0.07±0.16 (P=0.008). The slight underestimate of Kt/V during follow-up suggests that annual V evaluations may be sufficient for dialysis dose quantification as the only risk is underestimating the actually delivered dialysis dose. However, the relationship between baseline albumin and the reduction in V over time may have nutritional value, and suggests more frequent V evaluations.
Journal: Kidney International - Volume 69, Issue 4, 2 February 2006, Pages 754–759