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首页> 外文期刊>Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association >Comparison of volume of blood processed on haemodialysis adequacy measurement sessions vs regular non-adequacy sessions.
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Comparison of volume of blood processed on haemodialysis adequacy measurement sessions vs regular non-adequacy sessions.

机译：血液透析充分性测量阶段与常规非充分性阶段之间处理的血液量的比较。

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BACKGROUND:Knowledge that adequacy measures such as the urea reduction ratio (URR) or Kt/V(urea) are being measured on haemodialysis may influence the behaviour of patients or staff such that the treatment may be better on those days. This study therefore tested the hypothesis that mean volume of blood processed (VBP), utilized as a surrogate for adequacy, is higher on adequacy measurement days than non-measurement days. METHODS:Patients were identified who had been on haemodialysis over the preceding 8 months. Primary outcome was the difference in the mean VBP (in litres) on URR measurement compared with non-URR measurement days (DeltaVBP(U)(-N)). Univariate and multivariate correlates of mean VBP and DeltaVBP(U)(-N) were also determined. RESULTS:Eighty-nine patients were identified who met inclusion and exclusion criteria. Linear regression demonstrated a weak relationship between VBP and URR (r=0.24, P<0.02). This relationship was much stronger when VBP was adjusted for patient weight (mean VBP/weight; r=0.78, P<0.0001). The overall mean VBP was 87.4 l (+/-1.2 l) and the average DeltaVBP(U)(-N) was 1.1 l (+/-0.3 l) (P=0.001). Twenty per cent of patients had a clinically relevant DeltaVBP(U)(-N) of >3.6 l. Patients with a graft or fistula had a significantly higher DeltaVBP(U)(-N) than patients with a tunnelled catheter. CONCLUSIONS:This study demonstrates that the average VBP is less on non-URR than on URR measurement days; this difference was clinically important in >20% of patients. Univariate analysis indicated that the use of a fistula or graft correlated with a higher DeltaVBP(U)(-N). This implies that our current method of assessing dialysis adequacy does systematically overestimate the average delivered dose of dialysis in a subset of patients.
机译：背景：在血液透析中正在测量尿素减少率（URR）或Kt / V（尿素）等充分措施的知识可能会影响患者或医护人员的行为，以至于当日的治疗可能会更好。因此，这项研究检验了以下假设：在充足的测量日中，用作适当性替代指标的平均处理血量（VBP）高于非测量日。方法：确定在过去8个月内接受血液透析的患者。主要结果是URR测量的平均VBP（以升为单位）与非URR测量的天数（DeltaVBP（U）（-N））之间的差异。还确定了均值VBP和DeltaVBP（U）（-N）的单变量和多元相关性。结果：确定符合入选和排除标准的八十九名患者。线性回归表明VBP和URR之间的关系很弱（r = 0.24，P <0.02）。当根据患者体重调整VBP时，这种关系要强得多（平均VBP /体重; r = 0.78，P <0.0001）。总体平均VBP为87.4 l（+/- 1.2 l），平均DeltaVBP（U）（-N）为1.1 l（+/- 0.3 l）（P = 0.001）。 20％的患者的临床相关DeltaVBP（U）（-N）> 3.6 l。移植或瘘管患者的DeltaVBP（U）（-N）明显高于隧穿导管的患者。结论：这项研究表明，非URR的平均VBP低于URR测量日。在> 20％的患者中，这种差异具有重要的临床意义。单因素分析表明，瘘管或移植物的使用与更高的DeltaVBP（U）（-N）相关。这意味着我们目前评估透析充分性的方法确实有系统地高估了一部分患者的平均透析剂量。

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