特集名 | 適正透析 -- エビデンスをめぐる課題 | |
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題名 | 適正腹膜透析とエビデンス (1) 透析量 | |
発刊年月 | 2007年 09月 | |
著者 | 伊丹 儀友 | 日鋼記念病院腎センター |
著者 | 上村 昌寛 | 日鋼記念病院腎センター |
【 要旨 】 | 1997年に米国腎臓財団は,DOQIガイドラインのCAPD適正透析量として腹膜と残腎機能を合わせた週Kt/V Urea 2.0,週Ccr 60 l / 1.73 m2を推奨した.その後,メキシコと香港において大規模な前向きの研究がなされ,週Kt/V Urea 2.0以上と週Kt/V Urea 1.7以上では生存率に差がないことが認められた.最近では,週Kt/V Urea 1.7を最低透析目標とするガイドラインが多い. 長期にわたり腹膜透析を継続している患者が多い日本で,人種差や体格を考慮して上記透析量が本当に良いのか,今後検討していくことが必要である. |
Theme | Issues of Evidence-based Adequate Dialysis Therapy | |
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Title | Adequate peritoneal dialysis and evidence : Dialysis dose | |
Author | Noritomo Itami | Kidney Center, Nikko Memorial Hospital |
Author | Masahiro Uemura | Kidney Center, Nikko Memorial Hospital |
[ Summary ] | The 1997 DOQI guidelines for adequate dose of CAPD recommended a combined residual renal and peritoneal dialysis weekly level of Kt/V urea of 2.0 and a weekly Ccr level of 60 l / 1.73 m2. Later, a large scale prospective study, conducted in Mexico and Hong Kong, showed that there was no difference in survival rates with a weekly Kt/V urea level of 2.0 or greater or a weekly Kt/V urea level of 1.7 or greater. Recently, there have been many guidelines formulated which express the minimum dialysis goal as a weekly Kt/V urea level of 1.7. In Japan, where there are a large number of patients receiving long-term peritoneal dialysis, the adequacy of the dialysis doses noted above should be analyzed taking into consideration race and body structure. The dialysis doses and background circumstances concerning current guidelines for various countries are outlined. |