Static intra-access pressure ratio does not correlate with access blood flow.
Static intra-access pressure ratio does not correlate with access blood flow.
复制标题
静态通路内压力比与通路血流量不相关。
DOI：
10.1111/j.1523-1755.2004.00946.x
复制
发表时间：
2004
影响因子：
19.6
通讯作者：
E. Peacock
中科院分区：
文献类型：
--
作者：
L. Spergel;J. Holland;S. Fadem;C. J. Mcallister;E. Peacock
背景
肾脏疾病结果质量倡议 (K/DOQI) 推荐访问流量 (Qa) 测量作为访问监测的首选方法。静态通路内压力比 (SIAPR) 测量是第二种选择的监测方法。这项前瞻性多中心研究的目的是调查 SIAPR 和 Qa 之间的关系，并检验 SIAPR 监测的前提，即高 SIAPR 是与血流动力学显着狭窄相关的低 Qa 的替代。
方法
SIAPR 和 Qa（HD01；Transonic Systems, Inc.，伊萨卡，纽约州，美国）每月对来自三个中心的 242 名患者 [146 例假体动静脉桥移植物 (AVG)、96 例自体动静脉瘘 (AVF)] 进行同步测量。 SIAPR 根据 K/DOQI 协议进行测量。
结果
AVG 中（分别为 R(2)= 0.0037 和 R(2)= 0.006，N= 730）或 AVF 中（分别为 R(2)= 0.0247 和 R(2)= 0.0329，N= 431）Qa 与静脉或动脉 SIAPR 之间没有相关性。在 AVG 中的高 SIAPR 测量值中，81% 和 50% 分别与 Qa > 或 = 600 和 Qa > 或 = 1000 mL/min 相关。在所研究的 AVG 中，41% (60/146) 的 Qa 始终较高 > 或 = 1000 mL/min。这些高 Qa AVG 中的 70% (42/60) 至少连续两次进行过高 SIAPR 测量，从而满足 K/DOQI SIAPR 转诊标准。此外，78% (14/18) 的 Qa > 或 = 1000 mL/min 的新 AVG 以及 86% (6/7) 的 Qa 最高 (> 或 = 2000 mL/min) 的 AVG 具有较高的 SIAPR。结果，这些高 Qa AVG（代表 K/DOQI Qa 标准中功能最佳的 AVG）被错误地定位为基于 SIAPR 测量的推荐目标。
结论
SIAPR 与 Qa 不相关，也不区分高 Qa 和低 Qa。因此，由于 SIAPR 监测用于检测临床显着狭窄的效用取决于与 Qa 的相关性，因此目前基于 K/DOQI SIAPR 绝对阈值进行干预的使用（基于此类阈值指示低 Qa 的假设）是不合理的，应停止使用。需要进行研究来检验 SIAPR 在趋势分析中的实用性。
BACKGROUND
Access flow (Qa) measurement is recommended by Kidney Disease Outcomes Quality Initiative (K/DOQI) as the preferred method for access surveillance. Static intra-access pressure ratio (SIAPR) measurement is the second surveillance method of choice. The purpose of this prospective multicenter study was to investigate the relationship between SIAPR and Qa and to examine the premise upon which SIAPR surveillance is based-namely, that high SIAPR is a surrogate for low Qa associated with hemodynamically significant stenosis.
METHODS
SIAPR and Qa (HD01; Transonic Systems, Inc., Ithaca, NY, USA) were simultaneously measured monthly in 242 patients [146 prosthetic arteriovenous bridge grafts (AVG), 96 autogenous arteriovenous fistulas (AVF)] from three centers. SIAPR was measured according to the K/DOQI protocol.
RESULTS
There was no correlation between Qa and venous or arterial SIAPR in AVGs (R(2)= 0.0037 and R(2)= 0.006, respectively, N= 730), or in AVFs (R(2)= 0.0247 and R(2)= 0.0329, respectively, N= 431). Of the high SIAPR measurements in AVGs, 81% and 50% were associated with Qa > or =600 and Qa > or =1000 mL/min, respectively. Of the AVGs studied, 41% (60/146) had consistently high Qa > or =1000 mL/min. Seventy percent (42/60) of these high-Qa AVGs had at least two consecutive sessions with high SIAPR measurements, thereby meeting the K/DOQI SIAPR criteria for referral. In addition, 78% (14/18) of new AVGs with Qa > or =1000 mL/min, and 86% (6/7) of AVGs with the highest Qa (> or =2000 mL/min), had high SIAPR. As a result, these high-Qa AVGs, which represented the best functioning AVGs by K/DOQI Qa standards, were erroneously targeted for referral based on SIAPR measurements.
CONCLUSION
SIAPR does not correlate with Qa or discriminate between high and low Qa. Therefore, because the utility of SIAPR surveillance for detection of clinically significant stenosis depends on a correlation with Qa, the current use of absolute K/DOQI SIAPR thresholds for intervention based on the presumption that such thresholds are indicative of low Qa is not justified, and should be discontinued. Studies need to be done to examine the utility of SIAPR for trend analysis.
α-生育酚的肾浓度：性别依赖性以及对 Han:SPRD 大鼠多囊肾病缺乏影响。
DOI：
10.1053/ajkd.1998.v31.pm9531187
发表时间：
1998
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Torres,VE;Bengal,RJ;Nickander,KK;Grande,JP;Low,PA
通讯作者：
Low,PA
影响因子：
15.9
作者：
Korners, R;Lindsley, JN;Anderson, S
通讯作者：
Anderson, S
多囊大鼠对肾质量减少的适应受损。
DOI：
10.1016/s0272-6386(00)70264-2
发表时间：
2000
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Kang,SH;Oyama,TT;Kennefick,TM;Thompson,MM;Anderson,S
通讯作者：
Anderson,S