Muhammad Anees, Noman Butt, Irfan Elahi, Muhammad Shahbaz Pervaiz, Faiqa Saeed Butt
{"title":"血液透析充分性：紫外线与计算方法。","authors":"Muhammad Anees, Noman Butt, Irfan Elahi, Muhammad Shahbaz Pervaiz, Faiqa Saeed Butt","doi":"10.29271/jcpsp.2025.05.596","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare measuring methods of haemodialysis adequacy; realtime urea reduction ratio (RT-URR) and realtime Kt/V (RT- Kt/V) with calculated urea reduction ratio (C-URR) and calculated Kt/V (C-Kt/V), respectively, in end-stage kidney disease (ESKD) patients.</p><p><strong>Study design: </strong>Cross-sectional prospective study. Place and Duration of the Study: Department of Nephrology, Mayo Hospital, King Edward Medical University, Lahore, Pakistan, from July to December 2023.</p><p><strong>Methodology: </strong>Patients on maintenance haemodialysis for more than 3 months via a well-functioning arteriovenous fistula were included, while patients with acute kidney injury and dialysis-related complications were excluded. Pre- and post-dialysis blood samples for urea measurement were sent to the laboratory. RT-URR and RT-Kt/V were measured by the NIKKISO-DBB-EXAES machine using the ultraviolet absorbance method on spent dialysate. By putting pre- and post-dialysis, urea values C-URR and C-Kt/V (Daugirdas formula) were calculated. RT-URR, C-URR, RT-Kt/V and C-Kt/V were analysed for correlation using the Bland-Altman graph.</p><p><strong>Results: </strong>Fifty patients were included, with a mean age of 45.18 ± 12.25 years. The majority (n = 29, 58%) were male. Major cause of ESKD was hypertension (n = 27, 54%), followed by diabetes mellitus (n = 16, 32%). The mean duration of dialysis was 54.16 ± 31.74 months, and the majority of patients, 29 (58%), were on thrice weekly dialysis. A positive statistically significant correlation was found between C-URR and C-Kt/V with RT-URR and RT-Kt/V, respectively (p <0.001). A significant negative correlation was found for body surface area (BSA) with C-URR (p <0.001) and RT-URR (p = 0.013). Also, a significant negative correlation of BSA with C-Kt/V (p <0.001) and RT-Kt/V (p = 0.008) was found.</p><p><strong>Conclusion: </strong>RT-URR and RT-Kt/V, being strongly correlated with C-URR and C-Kt/V, can precisely tell about adequacy of haemodialysis.</p><p><strong>Key words: </strong>Renal dialysis, Haemodialysis, Home, Urea, Ultraviolet rays, Haemodialysis solutions.</p>","PeriodicalId":54905,"journal":{"name":"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan","volume":"35 5","pages":"596-600"},"PeriodicalIF":0.7000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Haemodialysis Adequacy: Ultraviolet <em>vs.</em> Calculated Methods.\",\"authors\":\"Muhammad Anees, Noman Butt, Irfan Elahi, Muhammad Shahbaz Pervaiz, Faiqa Saeed Butt\",\"doi\":\"10.29271/jcpsp.2025.05.596\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare measuring methods of haemodialysis adequacy; realtime urea reduction ratio (RT-URR) and realtime Kt/V (RT- Kt/V) with calculated urea reduction ratio (C-URR) and calculated Kt/V (C-Kt/V), respectively, in end-stage kidney disease (ESKD) patients.</p><p><strong>Study design: </strong>Cross-sectional prospective study. Place and Duration of the Study: Department of Nephrology, Mayo Hospital, King Edward Medical University, Lahore, Pakistan, from July to December 2023.</p><p><strong>Methodology: </strong>Patients on maintenance haemodialysis for more than 3 months via a well-functioning arteriovenous fistula were included, while patients with acute kidney injury and dialysis-related complications were excluded. Pre- and post-dialysis blood samples for urea measurement were sent to the laboratory. RT-URR and RT-Kt/V were measured by the NIKKISO-DBB-EXAES machine using the ultraviolet absorbance method on spent dialysate. By putting pre- and post-dialysis, urea values C-URR and C-Kt/V (Daugirdas formula) were calculated. RT-URR, C-URR, RT-Kt/V and C-Kt/V were analysed for correlation using the Bland-Altman graph.</p><p><strong>Results: </strong>Fifty patients were included, with a mean age of 45.18 ± 12.25 years. The majority (n = 29, 58%) were male. Major cause of ESKD was hypertension (n = 27, 54%), followed by diabetes mellitus (n = 16, 32%). The mean duration of dialysis was 54.16 ± 31.74 months, and the majority of patients, 29 (58%), were on thrice weekly dialysis. A positive statistically significant correlation was found between C-URR and C-Kt/V with RT-URR and RT-Kt/V, respectively (p <0.001). A significant negative correlation was found for body surface area (BSA) with C-URR (p <0.001) and RT-URR (p = 0.013). Also, a significant negative correlation of BSA with C-Kt/V (p <0.001) and RT-Kt/V (p = 0.008) was found.</p><p><strong>Conclusion: </strong>RT-URR and RT-Kt/V, being strongly correlated with C-URR and C-Kt/V, can precisely tell about adequacy of haemodialysis.</p><p><strong>Key words: </strong>Renal dialysis, Haemodialysis, Home, Urea, Ultraviolet rays, Haemodialysis solutions.</p>\",\"PeriodicalId\":54905,\"journal\":{\"name\":\"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan\",\"volume\":\"35 5\",\"pages\":\"596-600\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.29271/jcpsp.2025.05.596\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.29271/jcpsp.2025.05.596","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Haemodialysis Adequacy: Ultraviolet vs. Calculated Methods.
Objective: To compare measuring methods of haemodialysis adequacy; realtime urea reduction ratio (RT-URR) and realtime Kt/V (RT- Kt/V) with calculated urea reduction ratio (C-URR) and calculated Kt/V (C-Kt/V), respectively, in end-stage kidney disease (ESKD) patients.
Study design: Cross-sectional prospective study. Place and Duration of the Study: Department of Nephrology, Mayo Hospital, King Edward Medical University, Lahore, Pakistan, from July to December 2023.
Methodology: Patients on maintenance haemodialysis for more than 3 months via a well-functioning arteriovenous fistula were included, while patients with acute kidney injury and dialysis-related complications were excluded. Pre- and post-dialysis blood samples for urea measurement were sent to the laboratory. RT-URR and RT-Kt/V were measured by the NIKKISO-DBB-EXAES machine using the ultraviolet absorbance method on spent dialysate. By putting pre- and post-dialysis, urea values C-URR and C-Kt/V (Daugirdas formula) were calculated. RT-URR, C-URR, RT-Kt/V and C-Kt/V were analysed for correlation using the Bland-Altman graph.
Results: Fifty patients were included, with a mean age of 45.18 ± 12.25 years. The majority (n = 29, 58%) were male. Major cause of ESKD was hypertension (n = 27, 54%), followed by diabetes mellitus (n = 16, 32%). The mean duration of dialysis was 54.16 ± 31.74 months, and the majority of patients, 29 (58%), were on thrice weekly dialysis. A positive statistically significant correlation was found between C-URR and C-Kt/V with RT-URR and RT-Kt/V, respectively (p <0.001). A significant negative correlation was found for body surface area (BSA) with C-URR (p <0.001) and RT-URR (p = 0.013). Also, a significant negative correlation of BSA with C-Kt/V (p <0.001) and RT-Kt/V (p = 0.008) was found.
Conclusion: RT-URR and RT-Kt/V, being strongly correlated with C-URR and C-Kt/V, can precisely tell about adequacy of haemodialysis.
期刊介绍：
Journal of College of Physicians and Surgeons Pakistan (JCPSP), is the prestigious, peer reviewed monthly biomedical journal of the country published regularly since 1991.
Established with the primary aim of promotion and dissemination of medical research and contributed by scholars of biomedical sciences from Pakistan and abroad, it carries original research papers, , case reports, review articles, articles on medical education, commentaries, short communication, new technology, editorials and letters to the editor. It covers the core biomedical health science subjects, basic medical sciences and emerging community problems, prepared in accordance with the “Uniform requirements for submission to bio-medical journals” laid down by International Committee of Medical Journals Editors (ICMJE). All publications of JCPSP are peer reviewed by subject specialists from Pakistan and locally and abroad.
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