Panzer Sarah E, Teitelbaum Isaac
Contrib Nephrol. 2012;178:11-15. doi: 10.1159/000337790. Epub 2012 May 25.
Proper volume management continues to be a major challenge in patients requiring renal replacement therapy. In patients performing peritoneal dialysis the introduction of icodextrin represented a major advance in this effort. Recent studies have demonstrated a potential role for the use of novel dialysis strategies employing icodextrin to further enhance ultrafiltration and to improve cardiac indices in patients with ultrafiltration failure. These alternative strategies include the use of icodextrin in non-traditional patient populations (low transporters), the simultaneous use of glucose-based and icodextrin solutions in combination, and the use of icodextrin twice daily rather than for just a single dwell. This paper will briefly review the current status of these alternative dialysis strategies with icodextrin. In addition, the potential role for icodextrin to decrease postoperative adhesions will be discussed as well.
对于需要肾脏替代治疗的患者而言，恰当的容量管理仍然是一项重大挑战。在进行腹膜透析的患者中，艾考糊精的引入是这方面的一项重大进展。近期研究表明，采用艾考糊精的新型透析策略在进一步增强超滤及改善超滤失败患者的心指数方面具有潜在作用。这些替代策略包括在非传统患者群体（低转运者）中使用艾考糊精、同时联合使用基于葡萄糖的溶液和艾考糊精溶液，以及每日使用两次艾考糊精而非仅单次留腹使用。本文将简要回顾这些使用艾考糊精的替代透析策略的现状。此外，还将讨论艾考糊精在减少术后粘连方面的潜在作用。
