Sezer S, Ozdemir N, Arat Z, Güz G, Sengül S, Akman B, Haberal A, Turan M, Haberal M
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
Adv Perit Dial. 2000;16:177-81.
A prospective study was planned to follow the clinical and laboratory data of hemodialysis (HD) patients after change of treatment to continuous ambulatory peritoneal dialysis (CAPD). Patients who had been on the HD program for more than 6 months were selected and followed for at least 6 months under CAPD treatment. Measured parameters included hemoglobin, ferritin, C-reactive protein (CRP), calcium, phosphorus, and intact parathyroid hormone (iPTH) levels; lipid profile; total protein and albumin; body mass index and triceps skin fold thickness; echocardiographic findings; and medications administered. We followed 34 patients (12 males, 22 females; mean age: 43.5 +/- 14.5 years; mean HD duration: 36.6 +/- 24.76 months) for a mean period of 19.8 +/- 11.9 months after change of treatment to CAPD. We saw a significant increase in mean hemoglobin, cholesterol, triglyceride, high-density lipoprotein (HDL), lipoprotein (a) [Lp(a)], phosphorus, and iPTH levels. We observed a decrease in erythropoietin dose, mean ferritin levels, systolic blood pressure (139.4 +/- 22.8 mmHg vs 114.4 +/- 21.0 mmHg, p = 0.001), diastolic blood pressure (85.7 +/- 12.6 mmHg vs 73.5 +/- 17.6 mmHg, p = 0.002), percentage of left ventricular hypertrophy, systolic and diastolic dysfunction, and the number of hypertensive drugs received. A significant improvement in the nutritional status of the patients (total protein, body mass index and triceps skin fold thickness) was also seen. In conclusion, CAPD treatment has a short-term outcome superior to that of HD in terms of better nutritional status and better control of hypertension and anemia.
一项前瞻性研究计划对接受血液透析（HD）治疗的患者改为持续性非卧床腹膜透析（CAPD）后的临床和实验室数据进行跟踪。选择接受HD治疗超过6个月的患者，并在CAPD治疗下至少跟踪6个月。测量参数包括血红蛋白、铁蛋白、C反应蛋白（CRP）、钙、磷和完整甲状旁腺激素（iPTH）水平；血脂谱；总蛋白和白蛋白；体重指数和肱三头肌皮褶厚度；超声心动图检查结果；以及所服用的药物。我们对34例患者（12例男性，22例女性；平均年龄：43.5±14.5岁；平均HD治疗时间：36.6±24.76个月）在改为CAPD治疗后平均随访了19.8±11.9个月。我们发现平均血红蛋白、胆固醇、甘油三酯、高密度脂蛋白（HDL）、脂蛋白（a）[Lp（a）]、磷和iPTH水平显著升高。我们观察到促红细胞生成素剂量、平均铁蛋白水平、收缩压（139.4±22.8 mmHg对114.4±21.0 mmHg，p = 0.001）、舒张压（85.7±12.6 mmHg对73.5±17.6 mmHg，p = 0.002）、左心室肥厚百分比、收缩和舒张功能障碍以及所服用降压药物数量均有所下降。患者的营养状况（总蛋白、体重指数和肱三头肌皮褶厚度）也有显著改善。总之，就更好的营养状况以及更好地控制高血压和贫血而言，CAPD治疗的短期效果优于HD治疗。
