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  1. Kt/V - Wikipedia
    • Rationale For Kt/V as A Marker of Dialysis Adequacy
    • Relation to Urr
    • Peritoneal Dialysis
    • Reason For Adoption
    • Criticisms/Disadvantages of Kt/V
    • External Links

    K (clearance) multiplied by t (time) is a volume (since mL/min × min = mL, or L/h × h = L), and (K × t) can be thought of as the mL or L of fluid (blood in this case) cleared of urea (or any other solute) during the course of a single treatment. V also is a volume, expressed in mL or L. So the ratio of K × t / Vis a so-called "dimensionless ratio" and can be thought of as a multiple of the volume of plasma cleared of urea divided by the distribution volume of urea. When Kt/V = 1.0, a volume of blood equal to the distribution volume of urea has been completely cleared of urea. The relationship between Kt/V and the concentration of urea C at the end of dialysis can be derived from the first-order differential equation that describes exponential decayand models the clearance of any substance from the body where the concentration of that substance decreases in an exponential fashion: where 1. C is the concentration [mol/m3] 2. tis the time [s] 3. K is the clearance [m3/s] 4. V is the vo...

    The URR or Urea reduction ratio is simply the fractional reduction of urea during dialysis. So by definition, URR = 1 -C/C0. So 1-URR = C/C0. So by algebra, substituting into equation (4) above, since ln C/C0 = – ln C0/C, we get:

    Kt/V (in the context of peritoneal dialysis) was developed by Michael J. Lysaghtin a series of articles on peritoneal dialysis. The steady-state solution of a simplified mass transfer equation that is used to describe the mass exchange over a semi-permeable membrane and models peritoneal dialysisis where 1. CB is the concentration in the blood [ mol/m3] 2. KD is the clearance [ m3/s ] 3. m ˙ {\\displaystyle {\\dot {m}}} is the urea mass generation [ mol/s ] This can also be written as: The mass generation (of urea), in steady state, can be expressed as the mass (of urea) in the effluent per time: where 1. CE is the concentration of urea in effluent [ mol/m3] 2. VE is the volume of effluent [ m3] 3. tis the time [ s ] Lysaght, motivated by Equations 6b and 6c, defined the value KD: Lysaght uses "ml/min" for the clearance. In order to convert the above clearance (which is in m3/s) to ml/min one has to multiply by 60 × 1000 × 1000. Once KD is defined the following equation is used to cal...

    Kt/V has been widely adopted because it was correlated with survival. Before Kt/V nephrologists measured the serum urea concentration (specifically thetime-averaged concentration of urea (TAC of urea)), which was found not to be correlated with survival (due to its strong dependence on proteinintake) and thus deemed an unreliable marker of dialysis adequacy.

    It is complex and tedious to calculate. Many nephrologists have difficulty understanding it.
    Kt/V only measures a change in the concentration of urea and implicitly assumes the clearance of urea is comparable to other toxins. (It ignores molecules larger than urea having diffusion-limited...
    Kt/V does not take into account the role of ultrafiltration.


    1. Hemodialysis Dose and Adequacy– a description of URR and Kt/V from the Kidney and Urologic Diseases Clearinghouse. 2. Kt/V and the adequacy of hemodialysis–

    Peritoneal dialysis

    1. Advisory on Peritoneal Dialysis– American Association of Kidney Patients 2. Peritoneal Dialysis Dose and Adequacy– a description of URR and Kt/V from the Kidney and Urologic Diseases Clearinghouse.


    1. spKt/V,eKt/V,URR,nPCR,GNRI etc. dialysis calculation– 2. free Kt/V calculators, single pool and equilibrated HD, PD, no login needed, site used by dozens of dialysis centers around the world for over 10 years– 3. Web/javascript program that does formal 2-pool urea kinetics in multiple patients– 4. Kt/V calculator– 5. Kt/V– HDCN

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