Iest C G, Vanholder R C, Ringoir S M
Nephrology Department, University Hospital, Ghent, Belgium.
Int J Artif Organs. 1989 Mar;12(3):159-64.
The literature offers scant data on loss of residual renal function in chronic haemodialysis patients. The present study was undertaken in 34 patients, to evaluate residual creatinine clearances (CCr) before the start of haemodialysis and after 3, 12 and 24 months. CCr progressively declined from 6.15 +/- 2.61 (before) to 1.40 +/- 1.29 ml.min-1 (after 24 months: p less than 0.01). The decrease was largest during the first three months of dialysis therapy (slope -0.99 +/- 1.01 ml.min-1.month-1 for the first three months vs. -0.23 +/- 0.12 ml.min-1.month-1 for the entire 24-month period: p less than 0.01). The decline in CCr during the first three months was significantly more pronounced in glomerular disease than in tubulo-interstitial disease (p less than 0.05). This could not be attributed to differences in blood pressure, body weight or hypotensive medications. Age and sex also had no influence. Our data indicate that there is a characteristic progressive loss of renal function in haemodialyzed patients and that the early decline is most pronounced in patients with glomerular disease. Regular assessment of residual renal function at least every three months is indicated in patients starting chronic haemodialysis treatment.
关于慢性血液透析患者残余肾功能丧失的文献资料匮乏。本研究对34例患者进行，以评估血液透析开始前以及透析3个月、12个月和24个月后的残余肌酐清除率（CCr）。CCr从6.15±2.61（透析前）逐渐下降至1.40±1.29 ml·min⁻¹（24个月后：p<0.01）。透析治疗的前三个月下降幅度最大（前三个月斜率为-0.99±1.01 ml·min⁻¹·月⁻¹，而整个24个月期间为-0.23±0.12 ml·min⁻¹·月⁻¹：p<0.01）。前三个月CCr的下降在肾小球疾病患者中比在肾小管间质疾病患者中更为明显（p<0.05）。这不能归因于血压、体重或降压药物的差异。年龄和性别也没有影响。我们的数据表明，血液透析患者存在特征性的肾功能进行性丧失，且早期下降在肾小球疾病患者中最为明显。开始慢性血液透析治疗的患者应至少每三个月定期评估残余肾功能。
