Renal Department, Royal London Hospital, , London, UK.
Postgrad Med J. 2013 Oct;89(1056):584-90. doi: 10.1136/postgradmedj-2012-131406. Epub 2013 Aug 1.
Most patients starting dialysis can choose between peritoneal dialysis and haemodialysis. There is little evidence proving that one form of dialysis is better than the other; although there may be an early advantage to peritoneal dialysis (PD) in young patients with residual function this effect is short-lived. Technique failure develops after years on PD so dialysis modality will often change during a long dialysis career. Quality of life studies, which must be interpreted carefully, indicate that patients require information about the impact of dialysis on their lifestyle as well as health-related outcomes so that they can choose the most suitable dialysis modality. Increasing numbers of frail elderly patients are starting dialysis; support in the home by nursing staff may facilitate the use of PD in this group. In the UK guidelines prioritise the patient's choice of dialysis modality (where feasible) based on good quality predialysis education. Cost of treatment is generally lower on PD, which is particularly recommended for patients with residual renal function and few comorbidities.
大多数开始透析的患者可以在腹膜透析和血液透析之间进行选择。几乎没有证据表明一种透析方式优于另一种；尽管对于仍有残余肾功能的年轻患者，腹膜透析（PD）可能有早期优势，但这种效果是短暂的。PD 治疗多年后会出现技术失败，因此在漫长的透析生涯中，透析方式通常会发生变化。生活质量研究必须谨慎解读，表明患者需要了解透析对其生活方式以及与健康相关的结果的影响，以便他们能够选择最适合的透析方式。越来越多体弱的老年患者开始透析；由护理人员提供家庭支持可能有助于该群体使用 PD。在英国，指南根据高质量的透析前教育，将患者对透析方式的选择（在可行的情况下）放在优先位置。PD 的治疗费用通常较低，对于仍有残余肾功能且合并症较少的患者特别推荐。
