Oba Ikuko, Shinozaki Michiya, Harada Kenji, Mori Takefumi, Kanai Hidetoshi
Division of Nephrology, Kokura Memorial Hospital, Kitakyushu, Japan.
Division of Nephrology, Kyushu Koseinenkin Hospital, Kitakyushu, Japan.
Adv Perit Dial. 2013;29:14-8.
Increased left ventricular mass index (LVMI) is commonly observed in patients undergoing peritoneal dialysis (PD). The present study aimed to determine the effect of icodextrin (Ico) on LVMI in PD patients with maintained residual renal function (RRF). This retrospective study included 18 patients (12 men, 6 women; average age: 62 +/- 10 years) diagnosed with indications for PD therapy and divided into two groups: those treated with Ico (Ico group) and without Ico (non-Ico group). Echocardiography was performed at the beginning of continuous ambulatory PD and after 6 and 12 months. A significant reduction in LVMI (p < 0.01) and an increase in ultrafiltration (p < 0.01) were observed after 6 months of lco treatment and were maintained for 12 months. Ejection fraction was significantly lower in the non-Ico group after 12 months (p < 0.01), but was not altered in the Ico group. Blood pressure, cardiothoracic ratio, urine volume, and N-terminal prohormone of brain natriuretic peptide were unaffected by PD treatment up to 12 months. The year-averaged ultrafiltration and the reduction in LVMI were significantly correlated (p < 0.05). Ico effectively improved LVMI and maintained ejection fraction in end-stage renal disease patients within 1 year from PD initiation. Notably, treatment with Ico resulted in a reduction of LVMI (associated with increased ultrafiltration), with no significant reduction in RRF.
接受腹膜透析(PD)的患者中,左心室质量指数(LVMI)升高较为常见。本研究旨在确定艾考糊精(Ico)对具有残余肾功能(RRF)的PD患者LVMI的影响。这项回顾性研究纳入了18例患者(12例男性,6例女性;平均年龄:62±10岁),这些患者被诊断为有PD治疗指征,并分为两组:接受Ico治疗的患者(Ico组)和未接受Ico治疗的患者(非Ico组)。在持续非卧床腹膜透析开始时以及6个月和12个月后进行超声心动图检查。Ico治疗6个月后观察到LVMI显著降低(p<0.01)和超滤增加(p<0.01),并持续12个月。12个月后,非Ico组的射血分数显著降低(p<0.01),但Ico组未发生改变。血压、心胸比率、尿量和脑钠肽N末端前体激素在长达12个月的PD治疗中未受影响。年平均超滤量与LVMI的降低显著相关(p<0.05)。Ico可有效改善终末期肾病患者从开始PD治疗起1年内的LVMI并维持射血分数。值得注意的是,Ico治疗导致LVMI降低(与超滤增加相关),而RRF无显著降低。