Passadakis P S, Thodis E D, Panagoutsos S A, Selisiou C A, Pitta E M, Vargemezis V A
Democritus University of Thrace, Division of Nephrology, G.D. Hospital of Alexandroupolis, Greece.
Adv Perit Dial. 2000;16:2-6.
For the present study, we investigated the peritoneal transport of fluid and solutes and the clinical outcomes of 44 continuous ambulatory peritoneal dialysis (CAPD) patients with various peritoneal transport characteristics. Based on 24-hour urine and dialysate collections and 4-hour dwell studies [peritoneal equilibration test (PET)], the patients were divided into two transport groups by dialysate-to-plasma ratio of creatinine at 240 minutes (D/PCr240). The groups consisted of 21 high transporters (D/P = 0.81; mean age: 63.9 +/- 8.2 years) and 23 patients of other transport types (D/P < 0.81; mean age: 67.1 +/- 7.3). Mean CAPD duration was 57.14 +/- 30.4 months and 39.14 +/- 30.4 months respectively (p = 0.07). Estimations were made of weight, body surface area (BSA), percent body water, plasma albumin (PA), Kt/Vurea, weekly creatinine clearance (TCCr), fluid removal, residual renal function, and normalized protein catabolic rate (nPCR). The results showed that high transporters had statistically significant, lower values for: (1) peritoneal fluid (p = 0.02); (2) estimated glomerular filtration rate (GFR: 0.5 +/- 0.77 mL/min vs 2.15 +/- 2.2 mL/min, p = 0.002); and (3) nPCR (0.66 +/- 0.16 g/kg/day vs 0.84 +/- 0.23 g/kg/day, p = 0.003). No statistically significant differences were observed with regard to the other parameters (BSA, PA, Kt/Vurea, TCCr). Cumulative survival rates at two and five years were 90% and 70% for all patients. No statistically significant difference was seen when comparing the survival curves of high transporters and patients of other transport types (p = 0.33, Cox's F-test). In conclusion, we saw no clear evidence that higher peritoneal permeability negatively influences clinical outcome. Other comorbid factors may be related in a more important way to the survival rate for CAPD patients.
在本研究中，我们调查了44例具有不同腹膜转运特征的持续性非卧床腹膜透析（CAPD）患者的腹膜液体和溶质转运情况以及临床结局。根据24小时尿液和透析液收集以及4小时留腹研究[腹膜平衡试验（PET）]，以240分钟时透析液与血浆肌酐比值（D/PCr240）将患者分为两个转运组。这两组分别为21例高转运者（D/P = 0.81；平均年龄：63.9±8.2岁）和23例其他转运类型患者（D/P < 0.81；平均年龄：67.1±7.3岁）。CAPD平均持续时间分别为57.14±30.4个月和39.14±30.4个月（p = 0.07）。对体重、体表面积（BSA）、身体水分百分比、血浆白蛋白（PA）、Kt/V尿素、每周肌酐清除率（TCCr）、液体清除量、残余肾功能和标准化蛋白分解代谢率（nPCR）进行了评估。结果显示，高转运者在以下方面具有统计学意义的较低值：（1）腹膜液（p = 0.02）；（2）估计肾小球滤过率（GFR：0.5±0.77 mL/分钟对2.15±2.2 mL/分钟，p = 0.002）；以及（3）nPCR（0.66±0.16 g/kg/天对0.84±0.23 g/kg/天，p = 0.003）。在其他参数（BSA、PA、Kt/V尿素、TCCr）方面未观察到统计学显著差异。所有患者在两年和五年时的累积生存率分别为90%和70%。比较高转运者和其他转运类型患者的生存曲线时未发现统计学显著差异（p = 0.33，Cox F检验）。总之，我们没有明确证据表明较高的腹膜通透性会对临床结局产生负面影响。其他合并因素可能在更重要的方面与CAPD患者的生存率相关。
