Maher J F
Uniformed Services University of the Health Sciences, Bethesda, Md.
Blood Purif. 1990;8(2):69-75. doi: 10.1159/000169927.
Endocrine-metabolic disturbances of renal failure have many underlying mechanisms, including abnormal secretion, transport, and target cell binding, impaired synthesis and elimination by the diseased kidney, and responses to stimuli resulting from altered homeostasis. Neither hemodialysis nor continuous ambulatory peritoneal dialysis (CAPD) removes large amounts of hormones. By correcting metabolic, fluid and electrolyte disturbances, dialysis may improve some endocrine abnormalities. Possibly because of more permeable membranes, or continuous treatment including ultrafiltration, CAPD has a somewhat more salutary effect on uremic endocrinopathy than hemodialysis. In particular, hormonal regulation of salt and water balance, erythropoietic function, female reproductive function, and some aspects of renal osteodystrophy respond more favorably to CAPD. The endocrine response suggests that there is no inferiority of CAPD as a treatment for renal failure.
肾衰竭的内分泌代谢紊乱有许多潜在机制，包括分泌异常、转运异常和靶细胞结合异常，患病肾脏的合成与清除功能受损，以及体内稳态改变所引发的刺激反应。血液透析和持续性非卧床腹膜透析（CAPD）均不能大量清除激素。通过纠正代谢、液体及电解质紊乱，透析可能改善一些内分泌异常情况。可能由于腹膜透析使用的膜通透性更高，或者其持续治疗方式包括超滤，相比于血液透析，CAPD对尿毒症内分泌病的疗效稍好。特别是，CAPD对盐和水平衡的激素调节、红细胞生成功能、女性生殖功能以及肾性骨营养不良的某些方面的反应更为良好。内分泌反应表明，作为肾衰竭的一种治疗方法，CAPD并无劣势。
