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无尿的持续非卧床腹膜透析和自动化腹膜透析患者的经腹膜钙平衡

Transperitoneal calcium balance in anuric continuous ambulatory peritoneal dialysis and automated peritoneal dialysis patients.

作者信息

Hamada Chieko, Tomino Yasuhiko

机构信息

Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan.

出版信息

Int J Nephrol. 2013;2013:863791. doi: 10.1155/2013/863791. Epub 2013 Jul 9.

Abstract

Backgrounds. Calcium (Ca) and bone metabolism in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients show a remarkable difference depending on dialysis modalities. The levels of serum Ca and phosphate (P) in HD patients fluctuate contributing to the intermittent and rapid removal of plasma solute unlike in CAPD. Characteristics of plasma solute transport in automated peritoneal dialysis (APD) patients are resembled with that in HD. The purpose of the present study was to examine the difference of transperitoneal Ca removal between APD and CAPD anuric patients. Subjects and Methods. Twenty-three APD anuric patients were enrolled in this study. Biochemical parameters responsible for transperitoneal Ca removal in 24-hour and 4-hour peritoneal effluents were analyzed on CAPD and APD. Results. Transperitoneal Ca removal on APD was smaller compared with that on CAPD. The Ca removal was related to the ultrafiltration during short-time dwell. Decrease of the Ca removal during NPD induced by short-time dialysate dwell caused negative or small Ca removal in APD patients. The levels of intact PTH were increased at the end of PET. Conclusion. It appears that short-time dwell and frequent dialysate exchanging might suppress the transperitoneal Ca removal in anuric APD patients.

摘要

背景。持续性非卧床腹膜透析(CAPD)和血液透析(HD)患者的钙(Ca)和骨代谢因透析方式不同而存在显著差异。与CAPD不同,HD患者的血清钙和磷(P)水平波动,这导致血浆溶质间歇性快速清除。自动腹膜透析(APD)患者的血浆溶质转运特征与HD患者相似。本研究的目的是探讨APD和CAPD无尿患者经腹膜钙清除的差异。对象与方法。本研究纳入了23例APD无尿患者。对CAPD和APD患者24小时和4小时腹膜流出液中负责经腹膜钙清除的生化参数进行分析。结果。与CAPD相比,APD的经腹膜钙清除量较小。钙清除与短时间驻留期间的超滤有关。短时间透析液驻留导致NPD期间钙清除减少,使APD患者的钙清除为负或较小。PET结束时完整PTH水平升高。结论。似乎短时间驻留和频繁更换透析液可能会抑制无尿APD患者的经腹膜钙清除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3c/3723151/21a065b0b0de/IJN2013-863791.001.jpg

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