期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

共查询到1条相似文献，搜索用时 0 毫秒

El Kt/V alto,a diferencia del Kt,se asocia a mayor mortalidad: importancia de la V baja

Rafael Pérez-García Maite Jaldo Roberto Alcázar Patricia de Sequera Marta Albalate Marta Puerta Mayra Ortega M. Caridad Ruiz Elena Corchete 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(1):58-66

Introduction

Kt/V has been used as a synonym for haemodialysis dose. Patient survival improved with a Kt/V > 1; this target was subsequently increased to 1.2 and 1.3. The HEMO study revealed no significant relationship between Kt/V and mortality. The relationship between Kt/V and mortality often shows a J-shaped curve. Is V the confounding factor in this relationship? The objective of this study is to determine the relationship between mortality and Kt/V, Kt and body water content (V) and lean mass (bioimpedance).

Methods

We studied a cohort of 127 prevalent haemodialysis patients, who we followed-up for an average of 36 months. Kt was determined by ionic dialysance, and V and nutrition parameters by bioimpedance. Kt/V, Kt corrected for body surface area (Kt/BSA) and target Kt/BSA were calculated. The mean data from 18,998 sessions were used as haemodialysis parameters, with a mean of 155 sessions per patient.

Results

Mean age was 70.4 ± 15.3 years and 61% were male; 76 were dialysed via an arteriovenous fistula and 65 were on online haemodiafiltration. Weight was 70.6 (16.8) kg; BSA 1.8 (0.25) m²; total body water (V) 32.2 (7.41) l and lean mass index (LMI) 11.1 (2.7) kg/m². Mean Kt/V was 1.84 (0.44); Kt 56.1 (7) l and Kt/BSA 52.8 (10.4) l. The mean target Kt/BSA was 49.7 (4.5) l. Mean Kt/BSA – target Kt/BSA +6.4 (7.0) l. Patients with a higher Kt/V had worse survival rates than others; with Kt this is not the case. Higher Kt/V values are due to a lower V, with poorer nutrition parameters. LMI and serum albumin were the parameters that best independently predicted the risk of death and are lower in patients with a higher Kt/V and lower V.

Conclusion

Kt/V is not useful for determining dialysis doses in patients with low or reduced body water. Kt or the Kt/BSA are proposed as an alternative. 相似文献