高级检索

    维持性血透患者stdKt/V与相关临床指标关系及应用价值

    Relationship between stdKt/V and related clinical indicators in patients with maintenance hemodialysis and its application value

    • 摘要: 目的 探讨维持性血透患者标准尿素清除指数(stdKt/V)与相关临床指标关系及应用价值。方法 选取在徐州医科大学附属医院血液净化中心治疗的105例维持性血液透析患者资料,根据stdKt/V达标情况进行分组,采用单因素及多重线性回归分析法筛选stdKt/V的独立影响因素。根据stdKt/V及尿素清除指数(Kt/V)不同达标情况进行分组研究,比较stdKt/V与Kt/V的差异。将stdKt/V>2.0的患者根据透析频率分组研究,比较2组患者一般资料和实验室检查结果,探究stdKt/V的应用价值。结果 与stdKt/V ≤ 2.0组相比,stdKt/V>2.0组患者血钙、血清白蛋白水平较高,干体质量较小,透析龄较短。多重线性回归分析显示干体质量、血清白蛋白水平与stdKt/V呈线性相关,是stdKt/V的独立影响因素。与均达标组患者相比,Kt/V 不达标、stdKt/V达标组患者Kt/V值较低,具有残余肾功能的患者比例较高,Kt/V 达标、stdKt/V 不达标组患者2次/周透析方案的患者比例较高。与3次/周组相比,2次/周组患者的Kt/V值较低,透析龄更短,超滤量较大,残余肾功能、肾小球滤过率(eGFR)水平方面更高,余临床及血液学参数相比差异无统计学意义。结论 stdKt/V纳入透析患者营养状况及患者体内容量控制情况。应用stdKt/V作为衡量透析充分性的指标,可筛选出stdKt/V和Kt/V达标情况存在差异的患者(尤见于具有残余肾功能、每周透析2次的患者),弥补Kt/V的不足。也可有效筛选出每周透析2次患者中透析充分的人群,更全面地评估透析充分性。

       

      Abstract: Objective To investigate the relationship between stdKt/V and related clinical indicators in patients with maintenance hemodialysis and its application value.Methods A total of 105 patients who underwent maintenance hemodialysis in Hemodialysis Center, the Affiliated Hospital of Xuzhou Medical University were selected. According to the achievement of stdKt/V, they were divided into different groups. The univariate and multiple linear regression analysis were used to screen the independent influencing factors of stdKt/V. The patients were grouped according to their stdKt/V and Kt/V values, and the differences between stdKt/V and Kt/V were compared. Patients with stdKt/V > 2.0 were investigated in groups according to dialysis frequency. Both groups were compared for general information and laboratory examination results, in order investigate the application value of stdKt/V.Results Patients in the stdKt/V >2.0 group showed higher levels of blood calcium and serum albumin, smaller dry body mass, and lower dialysis age than those in the stdKt/V ≤ 2.0 group. Multiple linear regression analysis showed that dry body mass and serum albumin levels were linearly correlated with stdKt/V, which were the independent factor of stdKt/V. Compared with patients in the all-attainment group, patients in the stdKt/V attainment and Kt/V non-attainment group had lower Kt/V values, with a higher proportion of residual renal function; there were a higher proportion of patients using dialysis twice/week regimen in the stdKt/V non-attainment and Kt/V attainment group. Compared with the three-times/week group, patients in the twice/week group had reduced Kt/V values, decreased dialysis age, increased ultrafiltration, and enhanced residual renal function and eGFR levels, without statistical differences in the remaining clinical and hematological parameters.Conclusions stdKt/V incorporates the nutritional status of dialysis patients and the volume control of the patient's body. Application of stdKt/V as a measurement of dialysis adequacy can screen out patients with different stdKt/V and Kt/V attainment, especially for those with residual renal function who dialyze twice per week, in order to compensate for the effect of Kt/V. stdKt/V can also effectively screen out patients who dialyze twice a week with dialysis adequacy, in order to assess the adequacy of dialysis.

       

    /

    返回文章
    返回