Lichodziejewska-Niemierko Monika, Chmielewski Michał, Dudziak Maria, Ryta Alicja, Rutkowski Bolesław
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland Department of Palliative Medicine, Medical University of Gdańsk, Poland
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland.
Perit Dial Int. 2016 May-Jun;36(3):257-61. doi: 10.3747/pdi.2015.00009. Epub 2015 Oct 16.
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Biocompatible fluids for peritoneal dialysis (PD) have been introduced to improve dialysis and patient outcome in end-stage renal disease. However, their impact on hydration status (HS), residual renal function (RRF), and dialysis adequacy has been a matter of debate. The aim of the study was to evaluate the influence of a biocompatible dialysis fluid on the HS of prevalent PD patients. ♦
The study population consisted of 18 prevalent PD subjects, treated with standard dialysis fluids. At baseline, 9 patients were switched to a biocompatible solution, low in glucose degradation products (GDPs) (Balance; Fresenius Medical Care, Bad Homburg, Germany). Hydration status was assessed through clinical evaluation, laboratory parameters, echocardiography, and bioimpedance spectroscopy over a 24-month observation period. ♦
During the study period, urine volume decreased similarly in both groups. At the end of the evaluation, there were also no differences in clinical (body weight, edema, blood pressure), laboratory (N-terminal pro-brain natriuretic peptide, NTproBNP), or echocardiography determinants of HS. However, dialysis ultrafiltration decreased in the low-GDP group and, at the end of the study, equaled 929 ± 404 mL, compared with 1,317 ± 363 mL in the standard-fluid subjects (p = 0.06). Hydration status assessed by bioimpedance spectroscopy was +3.64 ± 2.08 L in the low-GDP patients and +1.47 ± 1.61 L in the controls (p = 0.03). ♦
The use of a low-GDP biocompatible dialysis fluid was associated with a tendency to overhydration, probably due to diminished ultrafiltration in prevalent PD patients.
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已引入用于腹膜透析（PD）的生物相容性液体，以改善终末期肾病患者的透析效果和预后。然而，它们对水合状态（HS）、残余肾功能（RRF）和透析充分性的影响一直存在争议。本研究的目的是评估生物相容性透析液对PD患者HS的影响。♦
研究人群包括18名接受标准透析液治疗的PD患者。在基线时，9名患者改用低葡萄糖降解产物（GDPs）的生物相容性溶液（Balance；费森尤斯医疗，德国巴特洪堡）。在24个月的观察期内，通过临床评估、实验室参数、超声心动图和生物电阻抗光谱法评估水合状态。♦
在研究期间，两组患者的尿量下降情况相似。在评估结束时，HS的临床（体重、水肿、血压）、实验室（N末端脑钠肽前体，NTproBNP）或超声心动图指标也没有差异。然而，低GDP组的透析超滤量下降，在研究结束时，平均为929±404 mL，而标准液组为1317±363 mL（p = 0.06）。通过生物电阻抗光谱法评估的水合状态在低GDP患者中为+3.64±2.08 L，在对照组中为+1.47±1.61 L（p = 0.03）。♦
使用低GDP生物相容性透析液与水合过度的倾向有关，这可能是由于PD患者超滤减少所致。
