Ryckelynck Jean-Philippe, Goffin Éric, Verger Christian
CHU de Caen, avenue Georges-Clemenceau, 14033 Caen cedex 9, France.
Nephrol Ther. 2013 Nov;9(6):403-7. doi: 10.1016/j.nephro.2013.05.001. Epub 2013 Jun 12.
There are evidences supporting a positive impact of renal residual function (RRF) on survival and quality of life of dialysis patients. Many strategies are available in clinical practices to maintain RRF. Hemodiafiltration seems to be better that conventional hemodialysis and similar to peritoneal dialysis. Arterial hypotension in hemodialysis or dehydration in peritoneal dialysis are deleterious in terms of preservation of RRF. Loop diuretics increase urine volume and natriuresis, not RRF. Radiocontrast and aminoglycosides may be used safely. The benefits of ACE inhibitors and angiotensin II receptor blockers are debated but have positive effect on blood pressure control and cardiac function. Neither biocompatible solutions nor the modality of peritoneal dialysis have demonstrated benefits on RRF.
有证据支持残余肾功能（RRF）对透析患者的生存和生活质量具有积极影响。临床实践中有多种维持RRF的策略。血液滤过似乎比传统血液透析更好，且与腹膜透析相似。血液透析中的动脉低血压或腹膜透析中的脱水对RRF的保留是有害的。袢利尿剂增加尿量和尿钠排泄，但不增加RRF。可以安全使用放射性造影剂和氨基糖苷类药物。血管紧张素转换酶抑制剂和血管紧张素II受体阻滞剂的益处存在争议，但对血压控制和心脏功能有积极作用。生物相容性溶液和腹膜透析方式均未显示对RRF有好处。
