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- Title
A mechanistic analysis of the National Cooperative Dialysis Study (NCDS).
- Authors
Gotch, Frank A.; Sargent, John A.
- Abstract
The purpose of the NCDS was to determine the probability of clinical failure (PF) as a function of the level of dialysis and protein catabolic rate (per. g/kg/day). The level of dialysis prescribed in the NCDS was mechanistically defined as Kt/V (product of dialyzer urea clearance and treatment time divided by body urea volume), which exponentially determines decrease in BUN during dialysis and is also a mathematical analogue of per. BUN. Mechanistic analysis (MA) showed that PF was a discontinuous function of Kt/V as it was prescribed in the NCDS and that a dependence of PF on per could not be assessed because of the study design. The MA results were compared to those reported with statistical analysis (SA) that used BUN and per. The SA predicts PF is strongly dependent on per with nutrition-dependent high PF for per ≤ 0.8 and low PF with high per and intensive dialysis. The MA suggests SA results may not be valid because a continuous outcome function is assumed and. due to study design, Kt/V was a dependent variable of per and these two variables cannot be clearly separated by analysis of BUN and per alone.
- Subjects
DIALYSIS (Chemistry); PROTEINS; HEMODIALYZERS; ARTIFICIAL kidneys; THERAPEUTICS; UREA; URINALYSIS
- Publication
Kidney International, 1985, Vol 28, Issue 3, p526
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1985.160