期刊
NEPHROLOGY DIALYSIS TRANSPLANTATION
卷 33, 期 3, 页码 530-539出版社
OXFORD UNIV PRESS
DOI: 10.1093/ndt/gfw473
关键词
chronic hemodialysis; clearance; guidelines; hemodialysis; predialysis
资金
- National Institute of Diabetes, Digestive and Kidney Disease of the National Institutes of Health [K24-DK091419]
- AVEO
The purpose of the study was to explore the precision of an equation designed to estimate residual kidney urea clearance (K-RU) from interdialytic urine collection data and pre-hemodialysis (HD) serum urea nitrogen (SUN) in different hemodialysis treatment schedules. The generalizability of the proposed equation was tested in 32 731 HD treatments where urine was collected prior to a dialysis session, mostly for 24 h but sometimes longer, in patients being dialyzed 1-4 times/week. The residual kidney urea clearance estimating equation predicted a K-RU that matched the one computed by formal modeling within 5% in > 98% of sessions analyzed. The errors in estimated versus modeled K-RU for interdialytic intervals (IDIs) of 2, 3, 4 and 7 days, were 1.6 +/- 1.5%, -0.4 +/- 1.6%, 0.9 +/- 1.6%, and 1.5 +/- 1.2%, respectively. Percent errors were similar for schedules of 1-4/week with the exception of urine collection during the 2-day interval of a 2:5-day twice-weekly schedule; here error averaged 5.0 +/- 1.2%. Use of the average of the SUN values at the start and end of the collection period overestimated modeled K-RU by 11.3 +/- 4.5%, whereas an equation suggested by others underestimated modeled K-RU by -9.9 +/- 3.4%. The equation tested predicts values for K-RU that are similar to those obtained from formal urea kinetic modeling, with percent errors that only rarely exceed 5%. It gives relatively precise results for a wide range of HD treatment schedules, IDIs and urine collection periods.
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