Diaz-Buxo Jose A, White Sarah A, Himmele Rainer
Fresenius Medical Care North America, Waltham, Massachusetts, USA.
Adv Perit Dial. 2013;29:19-24.
Increased peritoneal clearance can compensate for reductions in renal solute removal in patients receiving peritoneal dialysis (PD); however there is abundant evidence to suggest that renal rather than peritoneal clearance contributes to clinical outcomes. We review the evidence investigating the impact of residual renal function (RRF) and peritoneal solute clearances on survival and quality of life in PD patients. We also provide a comparison of the relative contribution of RRF and peritoneal clearance to patient survival. In addition, mechanisms of survival benefit in patients with preserved renal function, factors contributing to RRF decline, and interventions that may limit the progressive loss of RRF are discussed.
在接受腹膜透析(PD)的患者中,腹膜清除率的增加可弥补肾脏溶质清除的减少;然而,有大量证据表明,对临床结局起作用的是肾脏清除率而非腹膜清除率。我们回顾了有关残余肾功能(RRF)和腹膜溶质清除率对PD患者生存及生活质量影响的研究证据。我们还比较了RRF和腹膜清除率对患者生存的相对贡献。此外,还讨论了保留肾功能患者生存获益的机制、导致RRF下降的因素以及可能限制RRF逐渐丧失的干预措施。