Grushka E, Garty J, Kristal B, Goldhammer E, Abineder E G, Shasha S M
Nephrology Unit, Haifa Medical Center (Bnei-Zion), Israel.
Isr J Med Sci. 1990 Jul;26(7):378-82.
Twenty patients undergoing intermittent peritoneal dialysis (IPD) and 20 patients on hemodialysis (HD) for end-stage kidney disease underwent Holter ECG monitoring for a continuous 24-h period, starting prior to the onset of dialysis and continuing until several hours after it. Clinically significant ventricular arrhythmias were found in only 2 of 20 patients in the HD group; no such ventricular arrhythmias were observed in the IPD group. Supraventricular arrhythmias were equally prevalent in both groups. Thus, the differences between IPD and HD are not great and it seems that HD is, at most, a mild arrhythmogenic procedure. However, in patients with proven heart disease or signs of left ventricular hypertrophy, peritoneal dialysis (intermittent or continuous ambulatory) appears to be preferable to HD.
20例终末期肾病接受间歇性腹膜透析(IPD)的患者和20例接受血液透析(HD)的患者进行了24小时动态心电图监测,从透析开始前持续至透析后数小时。血液透析组20例患者中仅2例发现具有临床意义的室性心律失常;腹膜透析组未观察到此类室性心律失常。两组室上性心律失常的发生率相同。因此,间歇性腹膜透析和血液透析之间的差异不大,似乎血液透析至多是一种轻度致心律失常的操作。然而,对于已证实患有心脏病或有左心室肥厚体征的患者,腹膜透析(间歇性或持续性非卧床腹膜透析)似乎比血液透析更可取。