Lobbedez Th, Pujo M, el Haggan W, Hurault de Ligny B, Levaltier B, Ryckelynck J Ph
Service de néphrologie, dialyse et transplantation rénale, Centre hospitalier universitaire de Caen.
Nephrologie. 2003;24(7):387-9.
Malnutrition is a frequent and serious problem for patients treated by peritoneal dialysis. Patients' survival depends on their nutritional status at the initiation of the dialysis treatment. Main malnutrition factors are inflammation, insufficient dialysis dose, peritoneal glucidic absorption and protein loss within the dialysate. These patients show a relationship between malnutrition, inflammation and cardiovascular diseases. To prevent malnutrition, it is necessary to reduce inflammation by improving dialysis solutions' biocompatibility and optimising the sodium regulation. The peritoneal membrane exposure to both glucose and its degradation products must also be reduced. In order to restrict protein losses, especially when peritoneal hyper permeability occurred, dialysis solutions containing amino acids can be used. Early dialysis treatment and a progressive increase of the dialysis dose corresponding to the decrease of the residual renal function can also be recommended.
营养不良是接受腹膜透析治疗的患者常见且严重的问题。患者的生存取决于透析治疗开始时的营养状况。主要的营养不良因素包括炎症、透析剂量不足、腹膜对糖类的吸收以及透析液中的蛋白质丢失。这些患者表现出营养不良、炎症与心血管疾病之间的关联。为预防营养不良，有必要通过改善透析液的生物相容性和优化钠调节来减轻炎症。还必须减少腹膜与葡萄糖及其降解产物的接触。为了限制蛋白质丢失，尤其是在发生腹膜高通透性时，可使用含氨基酸的透析液。也建议早期进行透析治疗，并随着残余肾功能的下降逐步增加透析剂量。
