Iqbal M Masud, Islam M Nurul, Mansur M Abul, Naeem G Maola, Sattar Humayun, Hossain R Mokarram, Mohsin Mohammed, Rahman M Habibur, Rashid H Ur
Department of Nephrology, SSMC & Mitford Hospital, Bangladesh.
Adv Perit Dial. 2005;21:85-9.
In the present study, we analyzed the short-term outcome of continuous ambulatory peritoneal dialysis (PD) and hemodialysis (HD) in a group of elderly Bangladeshi patients with diabetes. Over a period of 2 years, we tracked various parameters in 60 patients on maintenance dialysis (25 on PD, 35 on HD). Mean age of the patients was 62 +/- 12 years (PD) and 57 +/- 8 years (HD), p < 0.03. Pre-dialysis systolic blood pressures (SBP) were 156 +/- 12 mmHg and 160 +/- 15 mmHg, and diastolic blood pressures (DBP) were 86 +/- 7 mmHg and 84 +/- 6 mmHg, both p = nonsignificant (NS). Pre-dialysis serum creatinine (SCr) levels were 1036 +/- 139 micromol/L and 1028 +/- 408 micromol/L, and daily urine volumes (UV) were 1.1 -/+ 0.4 L and 1 +/- 0.1 L, both also p=NS. At the end of the 2 years, durations of dialysis were 14 +/- 8 months (PD) and 13 +/- 12 months (HD), p=NS; SBPs were 142 +/- 15 mmHg and 155 +/- 18 mmHg, p < 0.004; DBPs were 81 +/- 6 mmHg and 80 +/- 7 mmHg, p=NS; and SCr levels were 538 +/- 154 micromol/L and 578 +/- 195 micormol/L, p=NS. The daily UVs had declined to 0.7 +/- 0.3 L and 0.3 +/- 0.3 L (p < 0.001) after periods of 12 +/- 7 months and 7 +/- 5 months (p < 0.001) respectively. During the study period, mortality in the PD group was 60% and in the HD group was 43% (p=NS). We conclude that elderly diabetic patients on PD have better control of blood pressure and maintain residual renal function longer than do similar patients on HD; at the same time, mortality in the two groups is comparable.
在本研究中，我们分析了一组患有糖尿病的孟加拉老年患者接受持续性非卧床腹膜透析（PD）和血液透析（HD）的短期结果。在2年的时间里，我们追踪了60例维持性透析患者（25例接受PD，35例接受HD）的各项参数。患者的平均年龄为62±12岁（PD组）和57±8岁（HD组），p<0.03。透析前收缩压（SBP）分别为156±12mmHg和160±15mmHg，舒张压（DBP）分别为86±7mmHg和84±6mmHg，两者p值均无统计学意义（NS）。透析前血清肌酐（SCr）水平分别为1036±139μmol/L和1028±408μmol/L，每日尿量（UV）分别为1.1±0.4L和1±0.1L，两者p值也均为NS。在2年结束时，透析时长分别为14±8个月（PD组）和13±12个月（HD组），p=NS；SBP分别为142±15mmHg和155±18mmHg，p<0.004；DBP分别为81±6mmHg和80±7mmHg，p=NS；SCr水平分别为538±154μmol/L和578±195μmol/L，p=NS。每日尿量分别在12±7个月和7±5个月后降至0.7±0.3L和0.3±0.3L（p<0.001）。在研究期间，PD组的死亡率为60%，HD组为43%（p=NS）。我们得出结论，与接受HD的类似患者相比，接受PD的老年糖尿病患者血压控制更好，残余肾功能维持时间更长；同时，两组的死亡率相当。
