Davenport Andrew
University College London Center for Nephrology, Royal Free Hospital, University College London Medical School, London, United Kingdom.
Semin Dial. 2015 Jan-Feb;28(1):16-9. doi: 10.1111/sdi.12320. Epub 2014 Nov 11.
The progressive loss of residual renal function in peritoneal dialysis patients is associated with increased mortality. It has been suggested that incremental dialysis may help preserve residual renal function and improve patient survival. Residual renal function depends upon both patient related and dialysis associated factors. Maintaining patients in an over-hydrated state may be associated with better preservation of residual renal function but any benefit comes with a significant risk of cardiovascular consequences. Notably, it is only observational studies that have reported an association between dialysis patient survival and residual renal function; causality has not been established for dialysis patient survival. The tenuous connections between residual renal function and outcomes and between incremental hemodialysis and residual renal function should temper our enthusiasm for interventions in this area.
腹膜透析患者残余肾功能的逐渐丧失与死亡率增加相关。有人提出增加透析量可能有助于保留残余肾功能并提高患者生存率。残余肾功能取决于患者相关因素和透析相关因素。使患者维持在轻度水合状态可能与更好地保留残余肾功能有关，但任何益处都伴随着心血管不良后果的重大风险。值得注意的是，仅有观察性研究报告了透析患者生存率与残余肾功能之间的关联；尚未确定透析患者生存率的因果关系。残余肾功能与预后之间以及增量血液透析与残余肾功能之间的微弱联系应抑制我们对该领域干预措施的热情。
