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首页> 外文期刊>Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy >Indirect Ion Selective Electrode Methods Potentially Overestimate Peritoneal Dialysate Sodium Losses
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Indirect Ion Selective Electrode Methods Potentially Overestimate Peritoneal Dialysate Sodium Losses

机译：间接离子选择电极方法可能高估了腹膜透析液的钠损失

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Measurements of dialysate sodium are used to estimate peritoneal dialysis sodium losses and sodium sieving, a measure of hydraulic permeability of the peritoneum. Peritoneal dialysates differ from serum samples in terms of pH, osmolality, protein and glucose concentration. We wished to determine whether these factors affected sodium measurement. Dialysate samples were taken from 52 consecutive peritoneal dialysis patients attending for a standard peritoneal dialysis equilibrium test (PET), 20 with standard lactate dialysate and 32 with neutral pH dialysate and sodium was measured by both flame photometry and indirect ion selective electrode (ISE). Sodium measured by ISE consistently overestimated that measured by flame photometer, mean bias 1.5mmol/L (95% confidence limits 1.2 to 1.8), P<0.001. Sodium was lower in fresh neutral pH dialysates by both methods - flame 125.3±1.17 vs. 131.6±0.39mmol/L, than standard lactate dialysates ISE 127.4±1.05 vs 132.7±0.27mmol/L, P<0.001. Glucose was higher in fresh neutral pH dialysates 122.7±1.1 vs. standard lactate dialysates 116.7±0.4mmol/L, P<0.001. On multiple regression analysis, only glucose was found to be an independent factor for sodium measurement, F=14.78, β=-0.0851, SEM 0.022, 95% confidence limits -1.28 to -0.042. In this study there was a small but consistent difference between sodium measurements by ISE and flame photometry during the PET. Sodium measurements by either method appeared to be affected by hypertonic dialysates, but there were differences with pH. This may potentially lead to errors in both overestimating peritoneal sodium losses and the proportion of patients with ultrafiltration failure due to loss of sodium sieving.
机译：透析液钠的测量被用于估计腹膜透析钠损失和钠筛分，这是腹膜水力渗透性的量度。腹膜透析液在pH，摩尔渗透压浓度，蛋白质和葡萄糖浓度方面与血清样品不同。我们希望确定这些因素是否影响钠的测量。透析液样本来自52例接受标准腹膜透析平衡测试（PET）的连续腹膜透析患者，其中20例采用标准乳酸透析液，32例采用中性pH透析液和钠，通过火焰光度法和间接离子选择性电极（ISE）进行了测量。 ISE测得的钠盐始终高估了火焰光度计测得的钠盐，平均偏差1.5mmol / L（95％置信区间1.2至1.8），P <0.001。两种方法在新鲜的中性pH透析液中的钠含量都较低-火焰125.3±1.17 vs.131.6±0.39mmol / L，比标准乳酸透析液ISE 127.4±1.05 vs 132.7±0.27mmol / L，P <0.001。新鲜的中性pH透析液中葡萄糖含量高于标准乳酸透析液116.7±0.4mmol / L，P <0.001。在多元回归分析中，仅发现葡萄糖是钠测量的独立因素，F = 14.78，β= -0.0851，SEM 0.022，95％置信限-1.28至-0.042。在这项研究中，在PET期间，通过ISE进行的钠测量与火焰光度法之间存在很小但一致的差异。两种方法中的钠测量值似乎都受到高渗透析液的影响，但pH值存在差异。这可能会导致高估腹膜钠损失以及由于钠筛分损失而导致超滤失败的患者比例的错误。

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