Kim Yong-Lim, Biesen Wim Van
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Renal Division, Ghent University Hospital, Ghent, Belgium.
Semin Nephrol. 2017 Jan;37(1):43-53. doi: 10.1016/j.semnephrol.2016.10.006.
Volume management in peritoneal dialysis patients is of importance, as both volume overload and dehydration are associated with worse outcomes. When assessing volume status, it is important to understand that different techniques measure different fluid compartments (intracellular vs extracellular vs circulating volume) and the impact of cardiac function. Attention to salt restriction and diuretics can help to maintain euvolemia without need for hypertonic bags. Glycaemia should be monitored to avoid thirst. Dwell length should be adapted to transport status: short dwells for fast transporters, long dwells in slow transporters. The role of bio-compatible solutions on volume control remains controversial.
腹膜透析患者的容量管理至关重要,因为容量超负荷和脱水均与较差的预后相关。在评估容量状态时,重要的是要明白不同的技术测量的是不同的液体腔室(细胞内液与细胞外液与循环容量)以及心脏功能的影响。注意限制盐分摄入和使用利尿剂有助于维持正常血容量,而无需使用高渗袋。应监测血糖以避免口渴。留腹时间应根据转运状态进行调整:快速转运者采用短留腹时间,缓慢转运者采用长留腹时间。生物相容性溶液在容量控制中的作用仍存在争议。