Selgas Rafael, Bajo M Auxiliadora, Cirugeda Antonio, del Peso Gloria, Valdés Jorge, Castro M José, Sánchez Sonia, Fernández-Reyes M José, Hevia Covadonga, Gil Fernando, Aguilera Abelardo, Ortiz Javier, Alegre Laura, Alvarez Vicente, Sánchez-Tomero J Antonio
Servicio de Nefrología, Hospital Universitario La Princesa, Madrid, Spain.
Perit Dial Int. 2005 Jan-Feb;25(1):68-76.
Human peritoneal function on commencing peritoneal dialysis (PD) is not yet adequately understood. The objective of this study was to determine peritoneal functional patterns on commencing PD.
367 end-stage renal disease (ESRD) patients on PD for the first time were studied between their initial second to sixth weeks on PD. Urea and creatinine mass transfer area coefficients (MTAC) and standardized ultrafiltration (UF) capacity were determined.
Mean parametric values were MTAC urea 22.9 +/- 7.04 mL/min, MTAC creatinine 10.31 +/- 4.68 mL/min, and UF 896 +/- 344 mL. Gender, patient size, and diabetes or kidney disease did not affect these parameters. The relationship between values of MTAC creatinine and UF reached statistical significance, although with a low value for Pearson's coefficient (r = -0.30, p = 0.001). Age showed a significant inverse linear correlation with UF capacity (r = -0.15, p = 0.003) and MTAC urea (r = -0.11, p < 0.05). Logistic regression analysis demonstrated that UF below 400 mL was independently related to a high MTAC creatinine and older age. Diabetes was least frequent in patients with the lowest UF. However, in the analysis of MTAC creatinine quintiles, UF values did not follow the expected inverse pattern. The lack of differences in UF between the second and third to fourth MTAC creatinine quintiles is remarkable; MTAC creatinine ranged from 6.71 to 13.54.
The functional characteristics of human peritoneum varied markedly and there was a less intense than expected relationship between solute and water transports. This mild inverse relationship is intriguing and suggestive of the necessity of redefining some basic concepts. Age was associated with a lower peritoneal UF capacity, in part independently of small solute transport.
人们对开始腹膜透析（PD）时的人体腹膜功能尚未有充分了解。本研究的目的是确定开始PD时的腹膜功能模式。
对367例首次接受PD治疗的终末期肾病（ESRD）患者在其PD初始的第二至六周进行了研究。测定了尿素和肌酐的物质转运面积系数（MTAC）以及标准化超滤（UF）能力。
参数均值为MTAC尿素22.9±7.04 mL/分钟，MTAC肌酐10.31±4.68 mL/分钟，UF 896±344 mL。性别、患者体型以及糖尿病或肾病均不影响这些参数。MTAC肌酐值与UF之间的关系具有统计学意义，尽管皮尔逊系数值较低（r = -0.30，p = 0.001）。年龄与UF能力（r = -0.15，p = 0.003）和MTAC尿素（r = -0.11，p < 0.05）呈显著负线性相关。逻辑回归分析表明，低于400 mL的UF与高MTAC肌酐和高龄独立相关。UF最低的患者中糖尿病最为少见。然而，在对MTAC肌酐五分位数的分析中，UF值并未呈现预期的相反模式。MTAC肌酐在第二与第三至第四五分位数之间UF缺乏差异，这一点很显著；MTAC肌酐范围为6.71至13.54。
人体腹膜的功能特征差异显著，溶质与水转运之间的关系不如预期紧密。这种轻度的反向关系很有趣，提示有必要重新定义一些基本概念。年龄与较低的腹膜UF能力相关，部分独立于小分子溶质转运。
