A method of comparison of different regimens for dialyzing single-pool solutes.
A method of comparison of different regimens for dialyzing single-pool solutes.
复制标题
比较单池溶质不同透析方案的方法。
DOI：
10.1097/mat.0b013e318224e67f
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Leonard,EdwardF
中科院分区：
文献类型：
--
作者：
John,Mira;Leonard,EdwardF
许多参考点已被用于比较和合理化体外终末期肾脏疾病治疗。我们讨论主题的一个特定部分：递送时间表对预定剂量的透析量的影响，例如，每周Kt/V。稳定(时不变)透析剂的应用绝对最小化任何可提取溶质的时间平均浓度和峰值浓度。然而，这样的剂量往往是不切实际的；我们评估可实现的缓慢方案相对于稳定剂量的有效性，使用单池近似，适用于缓慢方案。以前已经考虑过剂量计划。我们结合和讨论先前的观察结果，并建立连续剂量作为一个容易量化的参照点，我们强调不同时间表共同的基本模式。因此，我们可以使用两个直观参数来包含透析剂量：间歇性和强度，从而能够快速比较目前正在考虑的许多“慢”透析方案。这些参数定义了任何重复的透析模式。文中用公式、图解和实例给出了计算它们任意组合的方法。间歇处理仅略微增加了平均溶质浓度，但间歇处理的频率和间隔对峰值溶质浓度影响很大。随着更稳定的溶质去除，溶剂(水)储存的循环很可能仍然是患者失衡的主要来源。
Many points of reference have been used to compare and rationalize extracorporeal end-stage renal disease therapy. We address a specific part of the subject: the effect of the delivery schedule on a predetermined dose of dialysis, eg, weekly Kt/V. Steady (time-invariant) application of dialysis absolutely minimizes time-averaged and peak concentrations of any extractable solute. However, such dosing is often impractical; we assess the effectiveness of achievable slow regimens relative to steady dosing, using the single-pool approximation, applicable to slow regimens. Dose scheduling has been previously considered. We combine and discuss prior observations and establish continuous dosing as an easily quantifiable reference point, and we emphasize fundamental patterns common to different schedules. Thus, we enable rapid comparison of the many “slow” dialysis regimens presently under consideration using two intuitive parameters to encompass dialysis dosing: intermittency and intensity. These parameters define any repetitive dialysis pattern. A method for evaluating any combination of them is given with formulae, graphically, and with examples. Intermittency increases average solute concentration only slightly, but the frequency and spacing of intermittent treatments strongly affect peak solute concentrations. With steadier solute removal, cycling of solvent (water) stores is likely to remain the dominant source of disequilibrium in patients.