关键词: 血液透析, 透析充分性, 尿素清除指数, 尿素清除体积

Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore the necessity and rationality of evaluating hemodialysis adequacy by urea clearance index (Kt／V) combined with volume of urea clearecl (Kt), in order to analyze the factors affecting hemodialysis adequacy.
Ｍｅｔｈｏｄｏｌｏｇｙ：Using singlecenter, crosssectional and prospective study design, hemodialysis adequacy was assessed, and the hemodialysis patients were selected as research subjects from Suzhou Ninth People's Hospital. Blood samples were collected for testing before and after dialysis; singlepool Kt／V was calculated according to the daugirdas formula. targetKt was calculated according to the Lowrie’s formula.The study was grouped according to the compliance of Kt／V and Kt, and the relationship between hemodialysis adequacy and clinical parameters was analyzed. Meanwhile, the factors affecting Kt／V were analyzed by using logistic regression.
Ｒｅｓｕｌｔｓ：The Kt／V value was 162±046, and the number of Kt／V who met the standard was 125(6510％); The Kt value was 5353±1588 L, and the number of Kt who met the standard was 102 (5313％).the Kt value of Kt／V nonstandard group was lower than that of Kt／V standard group (4637±689 L vs 5736±1791 L,t=-608,P<001）; the value of V in Kt／V nonstandard group was higher than that in Kt／V standard group (3796±518 L vs 3110±490 L,t=907,P<001). Patients were divided into four groups based on whether Kt／V and Kt were met the criteria, and they were Group A (Kt／V and Kt are both up to standard), Group B (Kt／V and Kt are not up to standard), Group C (Kt／V was up to but Kt was not up to standard) and Group D (Kt／V was not up to but Kt was up to standard). The proportions of patients in the four group was as follows: 5000％、3021％、1667％ and 313％. Among them, Group A has the highest Kt value(6138±1868) L。Group D has the highest V value(4267±273)L。Logistic regression analysis results shows that: Dialysis mode(OR=619)、V(OR=1413)、Kt(OR=2934)and BMR(OR=019)are independent risk factors which can affect Kt／V.
Ｃｏｎｃｌｕｓｉｏｎ：Kt／V combined with Kt can identify special populations that are “relatively adequate” and “relatively inadequate”. Kt／V combined with Kt can more assess the sufficiency of Hemodialysis adequacy comprehensively and objectively.

Key words: hemodialysis, hemodialysis adequacyKt, Kt／V