CAPDにおける至適透析の評価: Kinetics modelingと臨床評価指数の有用性

至適CAPDを決定する因子を検討するため, CAPD 41名を対象とし, 蛋白異化率 (pcr), KT/V, クレアチニンクリアランス (CCr) および血清アルブミンを比較した. また臨床評価指数を測定し, 合計点数により3群に分類した. KT/Vとpcrの間には相関性を認め (r=0.55) 透析量が増すほど蛋白摂取量が増加することが示された. 臨床評価指数とよい相関を示したのはCCr (rs=0.52) であり次いでアルブミン (rs=0.38), KT/V (rs=0.31) であった. 3群間で差を認めたのはCCrと血清アルブミンでありKT/Vとpcrは全く差を認めなかった. 腹膜...

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Published in日本透析療法学会雑誌 Vol. 25; no. 10; pp. 1127 - 1132
Main Authors 森石, みさき, 土谷, 太郎, 高橋, 直子, 川西, 秀樹, 難波, 晋一郎, 豊田, 敏秀, 藤井, 辰義, 福田, 敏勝
Format Journal Article
LanguageJapanese
Published 社団法人 日本透析医学会 28.10.1992
Subjects
臨床評価指数
至適透析
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ISSN0911-5889
1884-6211
DOI10.4009/jsdt1985.25.1127

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Abstract 至適CAPDを決定する因子を検討するため, CAPD 41名を対象とし, 蛋白異化率 (pcr), KT/V, クレアチニンクリアランス (CCr) および血清アルブミンを比較した. また臨床評価指数を測定し, 合計点数により3群に分類した. KT/Vとpcrの間には相関性を認め (r=0.55) 透析量が増すほど蛋白摂取量が増加することが示された. 臨床評価指数とよい相関を示したのはCCr (rs=0.52) であり次いでアルブミン (rs=0.38), KT/V (rs=0.31) であった. 3群間で差を認めたのはCCrと血清アルブミンでありKT/Vとpcrは全く差を認めなかった. 腹膜炎, 合併症, 過去6か月入院の有無で差を認めたのは臨床評価指数と血清アルブミンであり次いでCCrであったが, KT/Vとpcrは全く差を示さなかった. 以上より, 至適CAPD決定因子として最も有用なものは血清アルブミンであり, 次いで透析量を表すCCrとKT/Vであると考えられた.
AbstractList 至適CAPDを決定する因子を検討するため, CAPD 41名を対象とし, 蛋白異化率 (pcr), KT/V, クレアチニンクリアランス (CCr) および血清アルブミンを比較した. また臨床評価指数を測定し, 合計点数により3群に分類した. KT/Vとpcrの間には相関性を認め (r=0.55) 透析量が増すほど蛋白摂取量が増加することが示された. 臨床評価指数とよい相関を示したのはCCr (rs=0.52) であり次いでアルブミン (rs=0.38), KT/V (rs=0.31) であった. 3群間で差を認めたのはCCrと血清アルブミンでありKT/Vとpcrは全く差を認めなかった. 腹膜炎, 合併症, 過去6か月入院の有無で差を認めたのは臨床評価指数と血清アルブミンであり次いでCCrであったが, KT/Vとpcrは全く差を示さなかった. 以上より, 至適CAPD決定因子として最も有用なものは血清アルブミンであり, 次いで透析量を表すCCrとKT/Vであると考えられた.
Author 藤井, 辰義
森石, みさき
土谷, 太郎
高橋, 直子
福田, 敏勝
川西, 秀樹
豊田, 敏秀
難波, 晋一郎
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References 10) Teehan BP, Schleifer CR, Brown JM, Sigler MH, Raimond J: Urea kinetic analysis and clinical outcome on CAPD. A five year longitudinal study. Adv Peri Dial 6: 181-185, 1990
3) Keshaviah PR, Nolph KD, Prowant B, Moore H, Ponferrada L, Van Stone JC, Twardowski ZJ, Khanna R: Defining adequacy of CAPD with urea kinetics. Adv Peni Dial 6: 173-177, 1990
5) Twardowski ZJ: Clinical value of standardized equilibration test in CAPD patients. Blood Purif 7: 95-108, 1989
2) Twardowski ZJ, Nolph KD, Khanna R, Prowant BF, Ryan LP, Moore HL, Nielsen MP: Peritoneal equilibration test. Peni Dial Bull 7: 138-146, 1987
13) Twardowski ZJ: PET-a simpler approach for adequate dialysis therapy. Adv Peni Dial 6: 186-191, 1990
9) Gotch FA: Application of urea kinetic modeling to adequacy of CAPD therapy. Adv Peni Dial 6: 178-180, 1990
12) Blake PG, Sombolos K, Abraham G, Weissgarten J, Pemberton R, Chu GL, Oreopoulos DG: Lack of correlation between urea kinetic indices and clinical outcomes in CAPD patients. Kidney Int 39: 700-706, 1991
8) Lindsay RM, Spanner E: The protein catabolic rate is dependent upon the type and amount of treatment in dialyzed uremic patients. Am J Kidney Dis 13: 382-389, 1989
11) Acchiardo SR, Kraus AP, Kaufman PA, LaHatte G, Adkins D, Moore LW: Evaluation of CAPD prescription. Adv Peni Dial 7: 47-50, 1991
15) Lowrie EG, Lew NL: Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis 15: 458-482, 1990
1) Lowrie EG, Laird NM: Cooperative dialysis study. Kidney Int 23: S1-S122, 1983
4) Randerson DH, Chapman GV, Farrell PC: Amino acid and dietary status in long-term CAPD patients. In “Peritoneal dialysis” ed Atkins RC, Farrell PC, Thomson N. p179-191, Edinburgh, Churchill-Livingstone, 1981
7) Keshaviah PR, Nolph KD, Van Stone JC: The peak concentration hypothesis: a urea kinetic approach to comparing the adequate of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. Peni Dial Int 9: 257-260, 1989
6) Gotch FA, Sargent JA: A mechanistic analysis of the national cooperative dialysis study (NCDS). Kidney Int 28: 526-534, 1985
14) Young GA, Kopple JD, Lindholm B, Vonesh EF, De Vecchi A, Scalamogna A, Castelnova C, Oreopoulos DG, Anderson GH, Bergstrom J, Di-Chiro J, Gentile D, Nissenson A, Sakhrani L, Brownjohn AM, Nolph KD, Prowant BF, Algrim CE, Martis L, Serkes KD: Nutritional assessment of continuous ambulatory peritoneal dialysis patients: an internal study. Am J Kidney Dis 17: 462-471, 1991
References_xml – reference: 5) Twardowski ZJ: Clinical value of standardized equilibration test in CAPD patients. Blood Purif 7: 95-108, 1989
– reference: 11) Acchiardo SR, Kraus AP, Kaufman PA, LaHatte G, Adkins D, Moore LW: Evaluation of CAPD prescription. Adv Peni Dial 7: 47-50, 1991
– reference: 3) Keshaviah PR, Nolph KD, Prowant B, Moore H, Ponferrada L, Van Stone JC, Twardowski ZJ, Khanna R: Defining adequacy of CAPD with urea kinetics. Adv Peni Dial 6: 173-177, 1990
– reference: 10) Teehan BP, Schleifer CR, Brown JM, Sigler MH, Raimond J: Urea kinetic analysis and clinical outcome on CAPD. A five year longitudinal study. Adv Peri Dial 6: 181-185, 1990
– reference: 6) Gotch FA, Sargent JA: A mechanistic analysis of the national cooperative dialysis study (NCDS). Kidney Int 28: 526-534, 1985
– reference: 7) Keshaviah PR, Nolph KD, Van Stone JC: The peak concentration hypothesis: a urea kinetic approach to comparing the adequate of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. Peni Dial Int 9: 257-260, 1989
– reference: 8) Lindsay RM, Spanner E: The protein catabolic rate is dependent upon the type and amount of treatment in dialyzed uremic patients. Am J Kidney Dis 13: 382-389, 1989
– reference: 12) Blake PG, Sombolos K, Abraham G, Weissgarten J, Pemberton R, Chu GL, Oreopoulos DG: Lack of correlation between urea kinetic indices and clinical outcomes in CAPD patients. Kidney Int 39: 700-706, 1991
– reference: 13) Twardowski ZJ: PET-a simpler approach for adequate dialysis therapy. Adv Peni Dial 6: 186-191, 1990
– reference: 2) Twardowski ZJ, Nolph KD, Khanna R, Prowant BF, Ryan LP, Moore HL, Nielsen MP: Peritoneal equilibration test. Peni Dial Bull 7: 138-146, 1987
– reference: 9) Gotch FA: Application of urea kinetic modeling to adequacy of CAPD therapy. Adv Peni Dial 6: 178-180, 1990
– reference: 4) Randerson DH, Chapman GV, Farrell PC: Amino acid and dietary status in long-term CAPD patients. In “Peritoneal dialysis” ed Atkins RC, Farrell PC, Thomson N. p179-191, Edinburgh, Churchill-Livingstone, 1981
– reference: 1) Lowrie EG, Laird NM: Cooperative dialysis study. Kidney Int 23: S1-S122, 1983
– reference: 14) Young GA, Kopple JD, Lindholm B, Vonesh EF, De Vecchi A, Scalamogna A, Castelnova C, Oreopoulos DG, Anderson GH, Bergstrom J, Di-Chiro J, Gentile D, Nissenson A, Sakhrani L, Brownjohn AM, Nolph KD, Prowant BF, Algrim CE, Martis L, Serkes KD: Nutritional assessment of continuous ambulatory peritoneal dialysis patients: an internal study. Am J Kidney Dis 17: 462-471, 1991
– reference: 15) Lowrie EG, Lew NL: Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis 15: 458-482, 1990
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Snippet 至適CAPDを決定する因子を検討するため, CAPD 41名を対象とし, 蛋白異化率 (pcr), KT/V, クレアチニンクリアランス (CCr) および血清アルブミンを比較した. また臨床評価指数を測定し, 合計点数により3群に分類した. KT/Vとpcrの間には相関性を認め (r=0.55)...
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SubjectTerms 臨床評価指数
至適透析
Title CAPDにおける至適透析の評価: Kinetics modelingと臨床評価指数の有用性
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Volume 25
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