Hong Kong Journal of Nephrology

Volume 6 Number 1, 2004

The Mathematical Basis, Clinical Application and Limitations of Ionic Dialysance

Vincent K.K. Tam

Morbidity and mortality in hemodialysis patients are closely related to dialysis adequacy. Unfortunately, in real life, the dialysis dose that is delivered during each hemodialysis session, for various reasons, may not even be close to that prescribed. It would be ideal if one could assess and verify the dialysis dose delivered in every dialysis treatment. Formal urea kinetic modeling (Kt/V) has been used widely to quantify the dialysis dosage. Recently, ionic dialysance is becoming more popular as a method to assess the delivered Kt/V of dialysis treatment. Its mathematical basis is reviewed, and its pitfalls, limitations and clinical relevance are briefly described.

Key words: ionic dialysance, urea clearance, online clearance, dialysis adequacy

血液透析接受者的預後(患病率及死亡率)與透析的足夠程度密切相關;遺憾的是,基於各種原因,病人實際上所接受的透析劑量,可能與指定的劑量相差甚遠。誠然,最理想的做法是可以在每次透析中評估並核實透析劑量。在透析液劑量的判定上,一般是採用尿素動力模型(Kt/V)。最近離子清除率(ionic dialysance)的使用日趨普及。本文簡單介紹了離子清除率的數學基礎、臨床相關性、及常見的誤解與限制。

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