摘要目的 研究观察维持性血液透析(MHD)患者透析后血清尿素反弹情况及相关影响因素.方法 稳定的MHD患者124例为埘象.取透析前、透析结束时、透析后15 min、30 min 血样,定量观察尿素反弹及其对透析充分性指标单室尿素清除指数(spKt/V)和血清尿素下降率(URR)的影响.分析其与患者人口学特征、透析参数的相关关系.结果 血液透析后的血清尿素反弹平均达13.6%,导致URR和spKt/V分别高估0.04和0.14.影响尿素反弹最重要的凶素是透析效率K/V,此外还有较高的血红蛋白、较多的相对超滤量、动静脉通路和男性.结论 血液透析后的尿素反弹普遍存在.对于特定的个体和透析过程,其对透析充分性指标的影响不能忽略.

abstractsObjective To study the urea rebound after hemodialysis in maintenance hemodialysis (MHD) patients and its impact factors. Methods From 124 stable MHD patients, blood samples were collected at the beginning, immediate post-hemodialysis, 15 minutes and 30 minutes after hemodialysis. The urea rebound was quantified, and its effect on URR and spKt/V was investigated. The impact factors on urea rebound were analyzed. Results In this group of patients, average post-hemodialytic urea rebound was 13.6%, leading to over-estimation of URR and spKt/V of 0.04 and 0.14, respectively. Hemodialysis efficiency expressed as K/V determined urea rebound most significantly. Other impact factors included higher hemoglobin, higher relative ultrafiltration, arteriovenous access, and male patients. Conclusions Urea rebound is common after the hemodialysis. For specific patients and hemodialysis sessions, ignoring it would result in significant over-estimation of delivered hemodialysis dose.