Correlation of breath ammonia with blood urea nitrogen and creatinine during hemodialysis
Correlation of breath ammonia with blood urea nitrogen and creatinine during hemodialysis
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DOI：
10.1073/pnas.071057598
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发表时间：
2001-04-10
影响因子：
11.1
通讯作者：
Patel, CKN
中科院分区：
文献类型：
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作者：
Narasimhan, LR;Goodman, W;Patel, CKN
我们用光谱法测定了7名终末期肾病患者在加州大学洛杉矶透析中心接受血液透析时的呼气氨水平。我们将这些测量结果与同时采集的血液样本相关联，这些血液样本用于分析血液尿素氮（BUN）和肌酐，这是指示患者血流中含氮废物负荷水平的公认标准。呼吸氨的初始水平，即，在透析开始时，在1，500 ppb和2，000 ppb（十亿分之一）之间。随着透析的进行，这些水平在前15-30分钟内急剧下降。我们发现，从这一点到透析治疗结束，呼吸氨浓度的降低相对缓慢，在透析治疗结束时，呼吸氨浓度在150至200 ppb之间逐渐降低。对于透析期间每隔15-30分钟进行的每次呼吸氨测量，我们还对患者的血液进行了BUN和肌酐采样。呼吸氨数据可在真实的时间内获得，而BUN和肌酐数据通常可在24小时后从实验室获得。我们发现呼气氨浓度与BUN和肌酐之间有很好的相关性。对于其中一名患者，呼吸氨和BUN相关性的相关性为0.95的R（2），呼吸氨和肌酐相关性的相关性为0.83的R（2）。这些初步数据表明，使用实时呼吸氨测量确定血液透析的疗效和终点的可能性。
We have spectroscopically determined breath ammonia levels in seven patients with end-stage renal disease while they were undergoing hemodialysis at the University of California, Los Angeles, dialysis center. We correlated these measurements against simultaneously taken blood samples that were analyzed for blood urea nitrogen (BUN) and creatinine, which are the accepted standards indicating the level of nitrogenous waste loading in a patient's bloodstream. Initial levels of breath ammonia, i.e., at the beginning of dialysis, are between 1,500 ppb and 2,000 ppb (parts per billion). These levels drop very sharply in the first 15-30 min as the dialysis proceeds. We found the reduction in breath ammonia concentration to be relatively slow from this point on to the end of dialysis treatment, at which point the levels tapered off at 150 to 200 ppb. For each breath ammonia measurement, taken at 15-30 min intervals during the dialysis, we also sampled the patient's blood for BUN and creatinine. The breath ammonia data were available in real time, whereas the BUN and creatinine data were available generally 24 h rater from the laboratory. We found a good correlation between breath ammonia concentration and BUN and creatinine. For one of the patients, the correlation gave an R(2) Of 0.95 for breath ammonia and BUN correlation and an R(2) Of 0.83 for breath ammonia and creatinine correlation. These preliminary data indicate the possibility of using the real-time breath ammonia measurements for determining efficacy and endpoint of hemodialysis.