Hamada Chieko, Honda Kazuho, Kawanishi Kunio, Nakamoto Hirotaka, Ito Yasuhiko, Sakurada Tsutomu, Tanno Yudo, Mizumasa Toru, Miyazaki Masanobu, Moriishi Misaki, Nakayama Masaaki
Division of Nephrology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan,
J Artif Organs. 2015 Sep;18(3):243-50. doi: 10.1007/s10047-015-0822-4. Epub 2015 Feb 14.
Peritoneal dialysis solution (PDS) plays a role in functional and morphological damage to the peritoneum. This study aimed to clarify the effect of neutral PDS in preventing morphological changes by assessing peritoneal damage and comparing morphological alterations between PD patients treated with neutral PDS and acidic PDS. Sixty-one patients participated from seven hospitals. All patients were treated with neutral PDS excluding icodextrin, during their entire PD treatment, and experienced no episode of peritonitis. The thickness of submesothelial compact (SMC) zone and the presence of vasculopathy in the anterior parietal abdominal peritoneum were assessed. The impact of icodextrin, hybrid therapy, and peritoneal rest and lavage in morphological alterations were determined. There was no significant difference in the average SMC thickness between neutral and acidic PDS. The vessel patency in patients using neutral PDS was significantly higher compared to that in acidic PDS at any time during PD. There were no significant suppressive effects from interventions or use of icodextrin with respect to peritoneal morphological injury. A monolayer of mesothelial cell was observed in approximately half the patients, especially in their receiving lavage patients. Neutral PDS, accompanied by other preventive approaches against peritoneal injury, might suppress the development of peritoneal morphological alterations.
腹膜透析液（PDS）在腹膜的功能和形态损伤中起作用。本研究旨在通过评估腹膜损伤并比较接受中性PDS和酸性PDS治疗的腹膜透析（PD）患者之间的形态学改变，来阐明中性PDS在预防形态学变化方面的作用。来自七家医院的61名患者参与了研究。所有患者在整个PD治疗期间均接受不含艾考糊精的中性PDS治疗，且未发生腹膜炎。评估了腹前壁腹膜间皮下致密（SMC）区的厚度以及血管病变情况。确定了艾考糊精、联合治疗以及腹膜休息和灌洗对形态学改变的影响。中性PDS和酸性PDS之间的平均SMC厚度无显著差异。在PD期间的任何时间，使用中性PDS的患者的血管通畅率均显著高于使用酸性PDS的患者。干预措施或使用艾考糊精对腹膜形态学损伤没有显著的抑制作用。在大约一半的患者中观察到单层间皮细胞，尤其是在接受灌洗的患者中。中性PDS与其他预防腹膜损伤的方法一起，可能会抑制腹膜形态学改变的发展。
