Setting of dry weight and the evaluation of vascular permeability in hemodialysis patients.

血液透析患者干体重的设定及血管通透性评估。

• 批准号: 12671045
• 负责人: TABEI Kaoru
• 金额: $ 2.11万
• 依托单位: Jichi Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12671045/
• 关键词: Hemodialysis; Dry weight; Proper weight; Vascular permeability; Atrial Natriuretic peptide; Brain Natriuretic peptide; Water removal rate; Clit-Line; ANP; BNP; 適正体重

Clinicians who manage maintenance hemodialysis patients are always suffered from the setting the dry weight. As for setting the dry weight, the cardiac size is the most useful index, however, other index such as human atrial natriuretic peptide, left atrial dimension, the diameter of inferior vena cava can be useful. The aim of this study is to make the flow chart to decide the dry weight.As for setting dry weight, we should know the hemodynamic changes during hemodialysis. We have examined the changes of circulating blood volume by monitoring hematocrit continuously by CLIT-LINE. As a result, in constant water removal, blood volume decreased linearly, at a rate of 3% of blood volume per 1% body weight water removal. However, in cases with hyponatremia and/or hypoproteinemia, the blood volume decreased markedly in the first 30 min. Moreover, the equipment of CLIT-LINE is expensive, therefore we utilized the protein concentration to know the circulating plasma volume. We nominate the new index of PWI (Plasma-water index) which is defined the ratio of the change in circulating plasma volume (%ΔCPV) by water removal (%ΔBW).I) PWI<2.0 1) stable blood pressure : down of dry weight,2) blood pressure decrease : find another reason to cause hemodialysis induced hypotention.II) PWI 2.0-4.0 1) stable blood pressure : good dry weight,2) blood pressure decrease : find another reason to cause hemodialysis induced hypotention.III) PWI>4.0 1) dry weight should be up.

维持溶解的临床医生总是患有干重的症状。干重的是，我们在血液透析过程中显示了Modynalnic的变化，我们通过在恒定的水中降低了血液的血液来检查循环的血液体积由于低钠血症和/或低蛋白质血症，在Clit-Line的第一次中，血液体积显着降低，因此，我们提名了PWI的新指数（血浆 - 沃特指数），以了解循环的等离子体体积。通过去除水（％ΔBW）的循环体积变化（％ΔCPV）的比率。 4.0 1）稳定的血压：良好的干重，2）血液降低：ypotence.iii）PWI> 4.0 1）应增加干重。

项目成果

Ookawara S, et al.: "Effect of postural change on blood volume in long-term hemodialysis patients"Nephron. 87. 27-34 (2001)

Ookawara S 等人：“姿势变化对长期血液透析患者血容量的影响”肾单位。

鈴木昌幸, 他: "維持透析患者の血液量に及ぼす体位変化の影響討"透析会誌. 33. 1325-1327 (2000)

Masayuki Suzuki 等人：“体位变化对维持性透析患者血容量的影响”《透析学会杂志》33. 1325-1327 (2000)。

大河原晋: "血液透析におけるplasma refilling coefficient (mean Kr) 算出の臨床的意義の検討"透析会誌. 34(8). 1185-1192 (2001)

Susumu Okawara：“血液透析中血浆再充盈系数（平均 Kr）计算的临床意义的检查”《透析学会杂志》34（8）1185-1192（2001）。

田部井薫, 他: "除水による蛋白濃縮度の意義の検討"透析会誌. 32. 1071-1077 (1999)

Kaoru Tabei 等人：“通过除水检测蛋白质浓度的重要性”，透析学会杂志 32. 1071-1077 (1999)。

Suzuki M, Ookawara S, Saitou M, Yahagi T, Tabei K.: "Effect of postural change on blood volume in long-term hemodialysis patients"J Jpn Soc Dial Ther. 33. 1325-1327 (2000)

Suzuki M、Ookawara S、Saitou M、Yahagi T、Tabei K.：“姿势变化对长期血液透析患者血容量的影响”J Jpn Soc Dial Ther。