Korean Journal of Nephrology 1991;10(4):555-562.

Urea Kinetic Modeling을 이용한 혈액투석 적절도 평가에 관한 연구

구완서 , 이숙영 , 김용수 , 박인석 , 김석영 , 장윤식 , 윤영석 , 방병기

Abstract

To assess the adequacy of hemodialysis urea kinetics stduy was performed in 123 chronic hemodialysis patients treated at St. Uincent hospital, Catholic Univer- sity Medical College. The following results were obtained. 1) Residual renal urea clearance of the hemodialysis patients was 0.77±1.35ml/min and creatinine clear- ance was 1.56±2.66ml/min. 2) Twenty-two percent of the homodialysis patients had protein catabolic rate of less than 0.8 g/kg/day. 3) There was a significant correlation between pro- tein catabolic rate and Kt/V urea per week (r=0.257, p <0. 01). 4) There were no significant correlations between protein catabolic rate and nutritional parameters such as body mass index and serum albumin. 5) There was a significant inverse correlation between protein catabolic rate and interdialysis interval (y= -0.0022x+1.0096, r= - 0.299, p<0.001). And there was a significant correlation between protein catabolic rate and frequency of hemodialysis (y=0.076x+0.616, r=0.307, p<0,001). 6) The patients dialyzed below 2 times per week had lower protein catabolic rate than the patients dialyzed over 2 times per week (0.90±0.16 vs 1,02±0.22 g/kg/ day, p<0.01). 7) Percent reduction of urea and Kt/V urea was correlated very well in the range of Kt/V urea between 0.8 and 1.4. From the above results, it seems that protein catabolic rate is dependent upon the frequency and amount of hemodialysis in chronic hemodialysis patients. A further study will be required to find out whether a significant correlation between protein catabolic rate and Kt/V urea per week is due to increased appetite or catabolic effect of hemodialysis itself. Calculation of percent reduction of urea is a simple, readily available and accurate method to estimate Kt/V urea.