Grzegorzewska A E, Uchman G
Department of Nephrology, K. Marcinkowski Academy of Medicine, Poznan, Poland.
Adv Perit Dial. 1990;6:19-22.
There is debate as to how much acetate in PD solutions influences the nUFV, so we decided to evaluate it during uncomplicated IPD and aseptic peritonitis connected with IPD treatment. In 8 patients dialysed with acetate (35 mmol/L) solutions for 9 +/- 8 months the nUFV (drainage volume minus instillation volume, mL/exchange) was calculated for 1.5 and 4.25% glucose exchanges during uncomplicated IPD and aseptic peritonitis. Then, lactate (35 mmol/L) buffered solutions were used instead of acetate ones and the nUFV was estimated under the same conditions. During uncomplicated IPD as well as peritonitis the nUFV was significantly higher in exchanges with lactate then with acetate solutions when the glucose concentration were comparable. In aseptic peritonitis the nUFV was less decreased with lactate than acetate solutions. We conclude during uncomplicated IPD or aseptic peritonitis in patients dialysed with acetate buffer the nUFV can be improved when acetate in PD solutions is substituted by lactate.
关于腹膜透析(PD)液中醋酸盐对净超滤量(nUFV)的影响程度存在争议,因此我们决定在单纯间歇性腹膜透析(IPD)以及与IPD治疗相关的无菌性腹膜炎期间对其进行评估。8例患者使用含醋酸盐(35 mmol/L)的透析液进行透析9±8个月,在单纯IPD和无菌性腹膜炎期间,计算1.5%和4.25%葡萄糖透析液交换时的nUFV(引流液量减去灌入液量,mL/次交换)。然后,使用乳酸盐(35 mmol/L)缓冲液替代醋酸盐缓冲液,并在相同条件下估算nUFV。当葡萄糖浓度相当时,在单纯IPD以及腹膜炎期间,使用乳酸盐透析液交换时的nUFV显著高于使用醋酸盐透析液交换时的nUFV。在无菌性腹膜炎中,乳酸盐透析液导致的nUFV降低幅度小于醋酸盐透析液。我们得出结论,在使用醋酸盐缓冲液透析的患者发生单纯IPD或无菌性腹膜炎时,用乳酸盐替代PD液中的醋酸盐可改善nUFV。