Hiramatsu Takeyuki, Hayasaki Takahiro, Hobo Akinori, Furuta Shinji, Kabu Koki, Tonozuka Yukio, Iida Yoshiyasu
Department of Nephrology, Aichi Welfare Cooperative Agricultural, Tokyo, Japan.
Baxter Limited, Tokyo, Japan.
Adv Perit Dial. 2013;29:4-8.
Icodextrin-based peritoneal dialysis (PD) has many advantages over glucose-based PD. The present study aimed to investigate when icodextrin should be started for better management of cardiovascular status (as defined by echocardiography findings) and residual renal function (RRF). We retrospectively analyzed 40 patients treated with continuous ambulatory PD or automated PD. The patients were divided into these groups: Group A: started icodextrin within 2 weeks after PD onset. Group B: started icodextrin 1 year after PD onset. Group C: started icodextrin 2 years after PD onset. Group D: never used icodextrin during the study period. At the start of PD, we observed no significant difference in left ventricular mass index (LVMI) or urine volume (UV) between the groups. At 4 years, LVMI and UV were both significantly improved in group A compared with group D. The amelioration in LVMI was negatively associated with phosphate elimination. Our study showed that icodextrin preserved RRF and ameliorated left ventricular hypertrophy. Moreover, the timing of icodextrin introduction in PD patients influenced the clinical effects, including progression of cardiac hypertrophy and RRF.
基于艾考糊精的腹膜透析（PD）相较于基于葡萄糖的PD有诸多优势。本研究旨在探讨何时开始使用艾考糊精以更好地管理心血管状况（由超声心动图检查结果定义）和残余肾功能（RRF）。我们回顾性分析了40例接受持续性非卧床腹膜透析或自动化腹膜透析治疗的患者。这些患者被分为以下几组：A组：在腹膜透析开始后2周内开始使用艾考糊精。B组：在腹膜透析开始1年后开始使用艾考糊精。C组：在腹膜透析开始2年后开始使用艾考糊精。D组：在研究期间从未使用过艾考糊精。在腹膜透析开始时，我们观察到各组之间左心室质量指数（LVMI）或尿量（UV）无显著差异。4年后，与D组相比，A组的LVMI和UV均显著改善。LVMI的改善与磷清除呈负相关。我们的研究表明，艾考糊精可保留RRF并改善左心室肥厚。此外，在腹膜透析患者中引入艾考糊精的时机影响临床效果，包括心脏肥厚的进展和RRF。
