López-Menchero R, Miguel A, García-Ramón R, Pérez-Contreras J, Girbés V
Department of Nephrology, Clinical Hospital, University of Valencia, Spain.
Nephron. 1999;83(3):219-25. doi: 10.1159/000045514.
To study the influence of residual renal function (RRF) on different parameters of the renal substitutive treatment offered by peritoneal dialysis.
We analyzed the impact of RRF on dialysis dose, nutrition parameters, anemia and phosphocalcic metabolism in 37 patients with end-stage renal disease (ESRD) treated by continuous ambulatory peritoneal dialysis (CAPD). Analytical controls were done every 6 months after an initial assessment at the end of the first month of treatment. Multiple lineal regression models were used as the statistical method to analyze the influence of RRF on different theoretically dependent factors. RRF was calculated as a mean of creatinine and urea clearances. Three observations per patient were used: one at the end of the first month of treatment; a final one at the end of follow-up (mean time 24.2 +/- 11.4 months), and at a mean time between them (13.4 +/- 6.7 months), with a final number of 111 observations.
Dialysis dose: RRF was the most important factor in terms of creatinine clearance (r(2) = 0.94; beta = 0.999), KT/V (r(2) = 0. 68; beta = 0.819) and beta(2)-microglobulin levels (r(2) = 0.46; beta = -0.489). Nutrition parameters: RRF was a determinant factor for normalized protein catabolic rate (r(2) = 0.53; beta = 0.471), percent lean body mass (r(2) = 0.45; beta = 0.446) and albumin levels (r(2) = 0.25; beta = 0.229). Anemia: RRF was the most important factor when studying hemoglobin levels (r(2) = 0.28; beta = 0.407). Phosphocalcic metabolism: Between the analyzed factors, RRF was the only one which reached significance on serum phosphate levels (r(2) = 0.19; beta = -0.594). RRF did not show any relationship with either calcium or PTH levels.
Independent of other factors, RRF in CAPD is positively and directly related to dialysis dose, beta(2)-microglobulin levels, nutrition parameters (albumin, normalized protein catabolic rate and percent lean body mass, hemoglobin and serum phosphate levels.
研究残余肾功能（RRF）对腹膜透析提供的肾脏替代治疗不同参数的影响。
我们分析了RRF对37例接受持续性非卧床腹膜透析（CAPD）治疗的终末期肾病（ESRD）患者的透析剂量、营养参数、贫血及钙磷代谢的影响。在治疗第一个月末进行初始评估后，每6个月进行一次分析对照。采用多元线性回归模型作为统计方法，分析RRF对不同理论相关因素的影响。RRF以肌酐清除率和尿素清除率的平均值计算。每位患者进行三次观察：一次在治疗第一个月末；最后一次在随访结束时（平均时间24.2±11.4个月），以及在这两次观察之间的平均时间（13.4±6.7个月），最终观察次数为111次。
透析剂量：就肌酐清除率（r² = 0.94；β = 0.999）、KT/V（r² = 0.68；β = 0.819）和β2-微球蛋白水平而言，RRF是最重要的因素（r² = 0.46；β = -0.489）。营养参数：RRF是正常蛋白分解代谢率（r² = 0.53；β = 0.471）、瘦体重百分比（r² = 0.45；β = 0.446）和白蛋白水平（r² = 0.25；β = 0.229）的决定因素。贫血：在研究血红蛋白水平时，RRF是最重要的因素（r² = 0.28；β = 0.407）。钙磷代谢：在分析的因素中，RRF是唯一对血清磷水平有显著影响的因素（r² = 0.19；β = -0.594）。RRF与钙或甲状旁腺激素水平均无关联。
独立于其他因素，CAPD中的RRF与透析剂量、β2-微球蛋白水平、营养参数（白蛋白、正常蛋白分解代谢率和瘦体重百分比）、血红蛋白及血清磷水平呈正相关且直接相关。
