Flanigan M J, Rocco M V, Frankenfield D L, Bailie G, Frederick P R, Prowant B F, Taylor L
Office of Clinical Standards & Quality, University of Iowa College of Medicine, Iowa City, IA 52240-4060, USA.
Am J Kidney Dis. 1998 Jul;32(1):E3. doi: 10.1053/ajkd.1998.v32.pm10074586.
The 1996 Peritoneal Dialysis-Core Indicators Study (PD-CIS) retrospectively reviews a random sample of peritoneal dialysis patients from the United States End-Stage Renal Disease (ESRD) program. Peritoneal dialysis (PD) patients are more likely to have a primary diagnosis of glomerulonephritis, less likely to be of African-American heritage, and are younger than hemodialysis patients. One third of PD patients now perform some form of automated peritoneal dialysis (APD) rather than continuous ambulatory peritoneal dialysis (CAPD). The dialysis prescriptions currently employed do not appear to be based on kinetic principles, and the intensity of dialysis achieved is below the proposed minimal guidelines for 30% of patients. In 1996, the mean dialysis index or wKt/Vurea for CAPD patients was 2.0 +/- 0.5 and was not significantly altered from the 1995 value of 2.1. Eighty-four percent of CAPD patients perform four or fewer exchanges daily, and only 27% of patients have prescriptions using infusion volumes greater than 2 L. Although hematocrits have improved since 1995, 30% of PD patients have a hematocrit below 30%. The mean serum albumin for PD patients is 3.5 g/dL, and 25% of patients have a 6-month average serum albumin value below 3.2 g/dL. In general, the indices monitored as predictive of health and well-being of PD patients afford significant opportunity for improvement.
1996年腹膜透析核心指标研究（PD-CIS）回顾性分析了来自美国终末期肾病（ESRD）项目的腹膜透析患者随机样本。腹膜透析（PD）患者更有可能以肾小球肾炎作为主要诊断，非裔美国人血统的可能性较小，且比血液透析患者年轻。现在三分之一的PD患者采用某种形式的自动化腹膜透析（APD），而非持续性非卧床腹膜透析（CAPD）。目前采用的透析处方似乎并非基于动力学原理，且30%的患者所达到的透析强度低于建议的最低指导标准。1996年，CAPD患者的平均透析指数或尿素清除率（wKt/Vurea）为2.0±0.5，与1995年的2.1值相比无显著变化。84%的CAPD患者每天进行四次或更少的换液，只有27%的患者处方使用的输注量大于2L。尽管自1995年以来血细胞比容有所改善，但30%的PD患者血细胞比容低于30%。PD患者的平均血清白蛋白为3.5g/dL，25%的患者6个月平均血清白蛋白值低于3.2g/dL。总体而言，作为预测PD患者健康和幸福状况所监测的指标有很大的改进空间。
