Holmes Clifford J
Renal Division, Baxter Healthcare, McGaw Park, Illinois 60085, USA.
J Diabetes Sci Technol. 2009 Nov 1;3(6):1472-80. doi: 10.1177/193229680900300629.
Peritoneal dialysis (PD) is a well-established form of therapy for stage 5 chronic kidney disease requiring renal replacement therapy. D-Glucose has been used successfully for several decades as the osmotic agent employed in dialysis solutions to achieve adequate fluid removal. The absorption of 100-200 grams of glucose per day has been suggested as potentially increasing cardiometabolic risk, particularly in patients with diabetes. Supporting and undermining evidence for this hypothesis is reviewed, with a focus on the role of glucose absorption in changes in body composition, dyslipidemia, and glycemic control in diabetic PD patients. Clinical strategies to optimize fluid removal while minimizing the metabolic impact of glucose absorption are also discussed.
腹膜透析(PD)是终末期慢性肾病需要肾脏替代治疗时一种成熟的治疗方式。几十年来,D -葡萄糖已成功用作透析液中的渗透剂,以实现充分的液体清除。有人提出,每天吸收100 - 200克葡萄糖可能会增加心脏代谢风险,尤其是糖尿病患者。本文综述了支持和反驳这一假说的证据,重点关注葡萄糖吸收在糖尿病腹膜透析患者身体成分变化、血脂异常和血糖控制中的作用。还讨论了在优化液体清除的同时尽量减少葡萄糖吸收代谢影响的临床策略。