Li Philip Kam-Tao, Kwong Vickie Wai-Ki
CUHK Carol and Richard Yu PD Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
CUHK Carol and Richard Yu PD Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
Semin Nephrol. 2017 Jan;37(1):2-9. doi: 10.1016/j.semnephrol.2016.10.002.
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD. Obviously, hemodialysis as another renal-replacement therapy modality also has its own areas that need attention and improvement by nephrologists and nurses. With more clinical and basic science research, outcome studies, and through better education and training, together with the implementation of global PD guidelines for enhancing care of PD patients, it is likely that such problem areas in PD gradually will be resolved and PD patient outcomes will be improved.
尽管全球范围内腹膜透析（PD）的使用在逐渐增加，但人们认识到，作为一种肾脏替代疗法，腹膜透析在许多方面仍需关注和改进。目前腹膜透析面临的挑战包括如何应对技术失败并维持长期腹膜透析、管理和预防腹膜感染、营养不良和炎症、心血管疾病死亡率、容量超负荷、葡萄糖暴露、溶质清除充分性、腹膜通路、腹膜生理以及长期腹膜透析带来的变化、患者疲劳、心理社会问题以及老年腹膜透析患者的护理。显然，血液透析作为另一种肾脏替代治疗方式也有其自身需要肾脏病学家和护士关注及改进的方面。随着更多临床和基础科学研究、结局研究，以及通过更好的教育和培训，再加上实施全球腹膜透析指南以加强对腹膜透析患者的护理，腹膜透析中此类问题领域有望逐步得到解决，腹膜透析患者的结局也将得到改善。
