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[持续性非卧床腹膜透析治疗糖尿病患者的腹膜溶质转运参数评估]

[Evaluation of peritoneal solute transport parameters in diabetics treated with continuous ambulatory peritoneal dialysis].

作者信息

Baczyński D, Marciniak M, Olszowska A, Waniewski J, Weryński A, Wańkowicz Z

机构信息

Kliniki Nefrologii ze Stacja Dializ Centralnego Szpitala Klinicznego Wojskowej Akademii Medycznej, Warszawie.

出版信息

Pol Merkur Lekarski. 1998 Nov;5(29):274-6.

Abstract

Increasing number of diabetics (D) on CAPD induced us to perform detailed kinetic evaluation of these patients. The purpose of the study was to characterize peritoneal solute transport parameters in diabetics and non-diabetics (ND) treated with CAPD and furthermore to assess clinical implications of eventual differences, especially with regard to programming the long-term CAPD in D. Twelve patients (7D and 5ND) on CAPD for 3-55 months were qualified to the investigation. They were clinically stable, with no impairment of ultrafiltration and free of peritonitis for at least 3 months. Four hours dwell studies with 2.0L of 3.86% glucose dialysis fluid were performed and mass transport coefficients (KBD) for glucose, potassium, sodium, total protein, urea and creatinine were calculated. No statistical differences for KBD between D and ND were found. However for every solute the average KBD values were higher in D that in ND. The observed differences do not justify any different treatment modality for D on peritoneal dialysis (PD). However high SD values, resulting from differences of peritoneal solute transport between patients, indicate the necessity of individualization of PD program.

摘要

接受持续性不卧床腹膜透析(CAPD)的糖尿病患者(D)数量不断增加,促使我们对这些患者进行详细的动力学评估。本研究的目的是描述接受CAPD治疗的糖尿病患者和非糖尿病患者(ND)的腹膜溶质转运参数,并进一步评估最终差异的临床意义,特别是在为糖尿病患者制定长期CAPD方案方面。12例接受CAPD治疗3至55个月的患者(7例糖尿病患者和5例非糖尿病患者)符合研究条件。他们临床稳定,超滤功能无损害,且至少3个月无腹膜炎。使用2.0L 3.86%葡萄糖透析液进行4小时驻留研究,并计算葡萄糖、钾、钠、总蛋白、尿素和肌酐的物质转运系数(KBD)。未发现糖尿病患者和非糖尿病患者之间的KBD有统计学差异。然而,对于每种溶质,糖尿病患者的平均KBD值均高于非糖尿病患者。观察到的差异并不能证明对糖尿病患者进行腹膜透析(PD)时采用任何不同的治疗方式是合理的。然而,由于患者之间腹膜溶质转运的差异导致的高标准差(SD)值表明有必要对PD方案进行个体化。

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