Ionic dialysance and the assessment of Kt/V: the influence of different estimates of V on method agreement.

التفاصيل البيبلوغرافية
العنوان:	Ionic dialysance and the assessment of Kt/V: the influence of different estimates of V on method agreement.
المؤلفون:	Moret K; Department of Internal Medicine, Máxima Medical Centre, Veldhoven, The Netherlands., Beerenhout CH, van den Wall Bake AW, Gerlag PG, van der Sande FM, Leunissen KM, Kooman JP
المصدر:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2007 Aug; Vol. 22 (8), pp. 2276-82. Date of Electronic Publication: 2007 Jun 05.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Oxford University Press Country of Publication: England NLM ID: 8706402 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0931-0509 (Print) Linking ISSN: 09310509 NLM ISO Abbreviation: Nephrol Dial Transplant Subsets: MEDLINE
أسماء مطبوعة:	Publication: Oxford : Oxford University Press Original Publication: [Berlin ; New York, NY] : Springer International, [c1986-
مواضيع طبية MeSH:	Ions/*chemistry, Female ; Glomerular Filtration Rate ; Humans ; Kidney/metabolism ; Kidney/physiology ; Kinetics ; Male ; Models, Statistical ; Models, Theoretical ; Reproducibility of Results ; Time Factors ; Urea/chemistry
مستخلص:	Background: Ionic dialysance was recently introduced as a means to assess Kt/V (K(ID)t/V). With this method, urea distribution volume (V) has to be estimated. The primary aim of the present study was to assess the agreement between equilibrated Kt/V assessed by urea kinetic modelling (eKt/V) with K(ID)t/V taking into account different estimates of V, and to assess the monthly variation in V. Secondly, the mechanisms behind the intra-treatment changes in ionic dialysance and inter-treatment variability of K(ID)t/V were assessed. Methods: Sixty-six patients were included. eKt/V was estimated using 30 min post-treatment sampling in the second generation Daugirdas equation. V was assessed by the formulae of Watson and Chertow (V(Watson); V(Chertow)), double-pool urea kinetic modelling (V(UKM)) and by ionic dialysance (V(IOD)) [Diascan; Hospal(R)]. Results: The use of V(UKM) or V(IOD) instead of V(Watson) or V(Chertow) improved the relation between eKt/V and K(ID)t/V (both r = 0.93; P < 0.001 vs r = 0.84 and r = 0.81; P < 0.001). Mean values of eKt/V (1.19 +/- 0.21), K(ID)t/V(UKM) (1.19 +/- 0.30) and K(ID)t/V(IOD) (1.21 +/- 0.25) were comparable. Intra-class correlation coefficient of V(IOD) was 0.87 with a 1-month interval and <0.75 after 2 and 3 months. Intra-class correlation coefficient of V(DP) was 0.79 with a 1-month interval and <0.75 after 2 and 3 months. Inter-treatment variation in K(ID)t/V during six consecutive dialysis sessions was 6.1% +/- 0.6%. Changes in blood flow were the main determinant of variations in K(ID)t/V (P < 0.05). During treatment, ionic dialysance decreased by 12 +/- 13 ml/min (P < 0.001). The decline in blood volume was the major determinant of the intra-dialytic change in ionic dialysance (P < 0.05). Conclusion: The use of V(IOD) and V(UKM) results in better agreement between eKt/V and K(ID)t/V compared with anthropometric formulae. K(ID)t/V was comparable with eKt/V and thus lower than expected for a single-pool method. V(IOD) and V(UKM), should be assessed at least monthly. K(ID)t/V varies widely between consecutive dialysis sessions, mainly due to differences in blood flow. During treatment, ionic dialysance decreases, which is related to the relative decline in blood volume.
التعليقات:	Erratum in: Nephrol Dial Transplant. 2007 Dec;22(12):3692.
المشرفين على المادة:	0 (Ions) 8W8T17847W (Urea)
تواريخ الأحداث:	Date Created: 20070607 Date Completed: 20071107 Latest Revision: 20220318
رمز التحديث:	20240628
DOI:	10.1093/ndt/gfm108
PMID:	17550929
قاعدة البيانات:	MEDLINE

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تدمد:	0931-0509
DOI:	10.1093/ndt/gfm108