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2型糖尿病患者应采用哪种透析方法?

[Which method of dialysis for the type 2 diabetic?].

作者信息

Vigneau C, Trolliet P, Labeeuw M, Pouteil-Noble C

机构信息

Service de néphrologie, Centre hospitalier Lyon-Sud, Pierre-Bénite.

出版信息

Nephrologie. 2000;21(4):173-8.

Abstract

Type 2 diabetes is becoming a major cause of chronic renal failure leading to health care problem. Literature data do not allow to choose between hemodialysis or peritoneal dialysis as the treatment of choice of end stage renal failure in type II diabetic patients according to their co-morbidities. A retrospective study was performed in 28 type II diabetic patients, either 11% of the total population, who started dialysis in our center between 1994 and 1997. Fourteen patients had chosen peritoneal dialysis and 14 hemodialysis. The 2 groups were not different for their initial neurological, cardiovascular, ophthalmological complications and for their metabolic control. After a mean follow-up of 14 months on dialysis a significant higher number of infections (9 versus 4), of hospitalisation days (34 +/- 19 versus 6.5 +/- 5.5), of technical transfers (6 versus 0) and of deaths (5 versus 0) were recorded in patients on peritoneal dialysis, without any difference in the metabolic control. A prospective, multicenter study is required to identify the best dialysis technique in type 2 diabetic patients, according to their co-morbidities and the dialysis dose.

摘要

2型糖尿病正成为导致慢性肾衰竭进而引发医疗保健问题的主要原因。文献数据无法依据Ⅱ型糖尿病患者的合并症情况,在血液透析或腹膜透析之间做出选择,以确定终末期肾衰竭的最佳治疗方式。我们对28例Ⅱ型糖尿病患者进行了一项回顾性研究,这些患者占1994年至1997年间在本中心开始透析的总人数的11%。14例患者选择了腹膜透析,14例选择了血液透析。两组患者在初始神经、心血管、眼科并发症及代谢控制方面并无差异。经过平均14个月的透析随访,腹膜透析患者的感染(9例对4例)、住院天数(34±19天对6.5±5.5天)、技术转换(6例对0例)及死亡(5例对0例)数量显著更高,而代谢控制方面并无差异。需要开展一项前瞻性多中心研究,以根据Ⅱ型糖尿病患者的合并症及透析剂量确定最佳透析技术。

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