Zhang Zhi-Yong, Zhou Chun-Hua, Li Ming-Xu, Yu Yong-Wu
Department of Nephrology, Naval General Hospital of PLA, Beijing 100048, P.R. China.
Exp Ther Med. 2012 Mar;3(3):519-524. doi: 10.3892/etm.2011.444. Epub 2011 Dec 30.
The objective of the present study was to investigate the long-term clinical efficacy of intermittent peritoneal dialysis (IPD) using various doses and to explore the most suitable dialysis dose and practice pattern for patients. A total of 52 inpatients/outpatients who had undergone IPD for more than 5 years were recruited and divided into three groups according to the dialysis dose: 4 liters in Group A, 6 liters in Group B and 8 liters in Group C. The dwell time was 4 h. All patients were fasted overnight. The dialysis adequacy, nutritional status, complication control, blood pressure and intra-abdominal infection were determined and observed among these patients. Barthel index (BI) and Hamilton Depression Scale (HAMD) were employed to measure the activities of daily living (ADL) and degree of depression, respectively. The dialysis adequacy and ultrafiltration volume in Group A were lower than those in Groups B and C, but the residual urine volume was larger than that in the latter two groups. In addition, there was a marked difference in the control of complications between Group A and Groups B and C. When compared to Groups A and B, the nutritional status in Group C was significantly decreased, the mean arterial pressure and intra-abdominal infection rates were dramatically increased, and the HAMD scores were also higher (P<0.05). No significant difference was noted in the BI. For patients undergoing long-term IPD, individualized dialysis dose may benefit the dialysis adequacy, nutritional status, control of complications, blood pressure, rate of intra-abdominal infection, ADL and depression.
本研究的目的是探讨不同剂量间歇性腹膜透析(IPD)的长期临床疗效,并为患者探寻最合适的透析剂量及操作模式。共招募了52例接受IPD治疗超过5年的住院/门诊患者,根据透析剂量分为三组:A组4升,B组6升,C组8升。留腹时间为4小时。所有患者均隔夜禁食。测定并观察这些患者的透析充分性、营养状况、并发症控制情况、血压及腹腔内感染情况。分别采用Barthel指数(BI)和汉密尔顿抑郁量表(HAMD)来衡量日常生活活动能力(ADL)和抑郁程度。A组的透析充分性和超滤量低于B组和C组,但残余尿量大于后两组。此外,A组与B组和C组在并发症控制方面存在显著差异。与A组和B组相比,C组的营养状况显著下降,平均动脉压和腹腔内感染率显著升高,HAMD评分也更高(P<0.05)。BI无显著差异。对于长期接受IPD治疗的患者,个体化透析剂量可能有利于透析充分性、营养状况、并发症控制、血压、腹腔内感染率、ADL及抑郁情况。