Bavbek Nüket, Akay Hatice, Altay Mustafa, Uz Ebru, Turgut Faruk, Uyar Mehtap E, Karanfil Aydyn, Selcoki Yusuf, Akcay Ali, Duranay Murat
Department of Nephrology, Fatih University Medical School, Harbiye Mah, Nigde Sokak, 46/2 Dikmen, Ankara, Turkey.
Perit Dial Int. 2007 Nov-Dec;27(6):663-8.
To compare ultrafiltration under continuous ambulatory peritoneal dialysis (CAPD) and automated PD (APD), disclosing potential effects on serum B-type natriuretic peptide (BNP) levels and echocardiographic findings.
This cross-sectional clinical study included 32 patients on CAPD and 30 patients on APD without clinical evidence of heart failure or hemodynamically significant valvular heart disease. Peritoneal equilibration tests, BNP levels, and echocardiographic measurements were performed in each subject. BNP measurements were also performed in 24 healthy control subjects.
Patients on APD had lower ultrafiltration and higher values of BNP and left ventricular mass index (LVMI) compared with patients on CAPD (respectively: 775 +/- 160 vs 850 +/- 265 mL, p = 0.01; 253.23 +/- 81.64 vs 109.42 +/- 25.63 pg/mL, p = 0.001; 185.12 +/- 63.50 vs 129.30 +/- 40.95 g/m(2), p = 0.001). This occurred despite higher mean dialysate glucose concentrations and far more extensive use of icodextrin in the APD group.
Treatment with APD is associated with higher plasma BNP levels and LVMI compared to CAPD. This may be the result of chronic fluid retention caused by lower ultrafiltration in APD patients.
比较持续性非卧床腹膜透析（CAPD）和自动化腹膜透析（APD）时的超滤情况，揭示其对血清B型利钠肽（BNP）水平及超声心动图检查结果的潜在影响。
这项横断面临床研究纳入了32例接受CAPD治疗的患者和30例接受APD治疗的患者，这些患者均无心力衰竭或血流动力学显著的瓣膜性心脏病的临床证据。对每位受试者进行了腹膜平衡试验、BNP水平检测及超声心动图测量。还对24名健康对照者进行了BNP检测。
与接受CAPD治疗的患者相比，接受APD治疗的患者超滤量较低，BNP及左心室质量指数（LVMI）较高（分别为：775±160 vs 850±265 mL，p = 0.01；253.23±81.64 vs 109.42±25.63 pg/mL，p = 0.001；185.12±63.50 vs 129.30±40.95 g/m²，p = 0.001）。尽管APD组的平均透析液葡萄糖浓度较高且更广泛地使用了艾考糊精，但仍出现了上述情况。
与CAPD相比，APD治疗与较高的血浆BNP水平及LVMI相关。这可能是APD患者超滤量较低导致慢性液体潴留的结果。
