Chen H C, Lai Y H, Tsai C Y, Tsai J H
Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi. 1990 Nov;6(11):621-7.
Peritoneal function is the major determinant of the efficiency of peritoneal dialysis. To understand whether diabetes affects the peritoneal function, we performed the peritoneal clearance study in 9 diabetic and 16 nondiabetic patients with end stage renal disease. The ultrafiltration volume tended to be lower in diabetics after infusion of 1.5% Dianeal, although there were no statistically significant differences between them. The same results were obtained after infusion of 4.25% Dianeal. The glucose uptake after infusion of both 1.5% and 4.25% Dianeal was not significantly different between the two groups. The dialysate/plasma(D/P) concentration ratio was also not significantly different between the two groups, however the D/P ratio for BUN and uric acid was slightly higher in the diabetic group. The peritoneal clearance of smaller molecules such as BUN, creatinine, uric acid and phosphate also tended to be higher in diabetics after infusion of 1.5% Dianeal for 4 hours. The peritoneal clearance became higher when more hyperosmotic dialysate were used in both diabetics and nondiabetics. The above results indicated that diabetic patients with end stage renal disease might have a normal peritoneal function compared to nondiabetics.
腹膜功能是腹膜透析效率的主要决定因素。为了解糖尿病是否会影响腹膜功能，我们对9例糖尿病终末期肾病患者和16例非糖尿病终末期肾病患者进行了腹膜清除率研究。输注1.5% 腹透液后，糖尿病患者的超滤量有降低趋势，尽管两组之间无统计学显著差异。输注4.25% 腹透液后也得到了相同结果。两组在输注1.5% 和4.25% 腹透液后的葡萄糖摄取无显著差异。两组的透析液/血浆（D/P）浓度比也无显著差异，然而糖尿病组的尿素氮和尿酸的D/P比略高。在输注1.5% 腹透液4小时后，糖尿病患者对尿素氮、肌酐、尿酸和磷酸盐等小分子物质的腹膜清除率也有升高趋势。在糖尿病患者和非糖尿病患者中，使用渗透压更高的透析液时腹膜清除率都会升高。上述结果表明，与非糖尿病患者相比，糖尿病终末期肾病患者可能具有正常的腹膜功能。
