Biesenbach G, Pohanka E
2nd Departement of Internal Medicine, General Hospital, Linz, Austria.
Minerva Urol Nefrol. 2012 Sep;64(3):173-82.
Both hemodialysis (HD) as well as peritoneal dialysis (PD), are efficient renal replacement therapies in uremic patients with and without diabetes. PD is less expensive dialysis modality and may provide a survival advantage over hemodialysis in first 2 to 4 years of treatment. Chronic ambulatory peritoneal dialysis (CAPD) as well as Continuous Cycler-Assisted Peritoneal Dialysis (CCPD) have additional advantages in patients with diabetes. PD therapy will be better tolerated than HD, the blood pressure is more stable and vascular access is not necessary. Preserving residual renal function (RRF) is of paramount importance to prolong the survival outcomes in PD patients. In insulin-dependent diabetic patients intraperitoneal insulin substitution can be used. The development of new, more biocompatible PD solutions holds promise for the future. Nevertheless, in many countries HD is further more favoured in the treatment of patients with ESRD.
血液透析（HD）和腹膜透析（PD）都是治疗有或无糖尿病的尿毒症患者的有效肾脏替代疗法。PD是成本较低的透析方式，在治疗的头2至4年可能比血液透析具有生存优势。持续性非卧床腹膜透析（CAPD）以及持续循环辅助腹膜透析（CCPD）对糖尿病患者还有其他优势。PD治疗比HD耐受性更好，血压更稳定且无需血管通路。保留残余肾功能（RRF）对于延长PD患者的生存结局至关重要。在胰岛素依赖型糖尿病患者中可采用腹膜内胰岛素替代治疗。新型、生物相容性更好的腹膜透析液的研发为未来带来了希望。然而，在许多国家，血液透析在终末期肾病患者的治疗中更受青睐。
