Fourtounas Costas, Hardalias Andreas, Dousdampanis Periklis, Papachristopoulos Basil, Savidaki Eirini, Vlachojannis Jannis G
Department of Internal Medicine-Nephrology, University of Patras, Patras, Greece.
Adv Perit Dial. 2008;24:27-31.
One of the main goals of dialysis is the control of extracellular volume, because inadequate sodium and fluid removal result in fluid overload and increased mortality. In the present study, we evaluated the roles of continuous ambulatory peritoneal dialysis (CAPD), continuous cycling peritoneal dialysis (CCPD), and the use of icodextrin on sodium removal in 29 patients (n = 18 on CAPD, n = 11 on CCPD). Daily removal of sodium by each modality and dialysis adequacy by Kt/V and creatinine clearance were evaluated. A significantly higher amount of sodium was removed in CAPD patients than in CCPD patients, although peritoneal dialysis clearances were lower in CAPD, and no difference in daily ultrafiltration was observed between the modalities. In the CAPD group, patients using icodextrin for the long dwell showed significantly increased 24-hour sodium removal (218 +/- 65 mmol/L) as compared with patients not using icodextrin (96.3 +/- 58 mmol/L, p < 0.001); they also showed increased daily ultrafiltration (1685 +/- 302 mL vs. 717 +/- 440 mL, p < 0.001). In the CCPD group, 8 patients were using icodextrin for the long dwell, and they showed significantly increased sodium removal only for the day exchange (43 +/- 49 mmol/L) as compared with patients not using icodextrin (-60 +/- 6, p < 0.001). Hypertension was less common in the CAPD patients than in the CCPD patients. These results indicate that CAPD is a more efficient modality than CCPD for sodium removal. Icodextrin is an effective tool not only for increasing adequacy, but also for removing more sodium in both modalities.
透析的主要目标之一是控制细胞外液量，因为钠和液体清除不充分会导致液体过载并增加死亡率。在本研究中，我们评估了持续性非卧床腹膜透析（CAPD）、持续性循环腹膜透析（CCPD）以及使用艾考糊精对29例患者（18例CAPD患者，11例CCPD患者）钠清除的作用。评估了每种方式的每日钠清除量以及通过Kt/V和肌酐清除率评估的透析充分性。尽管CAPD的腹膜透析清除率较低，但CAPD患者的钠清除量显著高于CCPD患者，并且两种方式之间的每日超滤量没有差异。在CAPD组中，长期使用艾考糊精的患者24小时钠清除量（218±65 mmol/L）显著高于未使用艾考糊精的患者（96.3±58 mmol/L，p<0.001）；他们的每日超滤量也增加（1685±302 mL对717±440 mL，p<0.001）。在CCPD组中，8例患者长期使用艾考糊精，与未使用艾考糊精的患者相比，他们仅在日间交换时钠清除量显著增加（43±49 mmol/L对-60±6，p<0.001）。CAPD患者的高血压发生率低于CCPD患者。这些结果表明，CAPD在钠清除方面比CCPD更有效。艾考糊精不仅是提高透析充分性的有效工具，而且在两种方式中都能去除更多的钠。
