Abrahams Alferso C, van Jaarsveld Brigit C
UMC Utrecht, afd. Nefrologie en Hypertensie, Utrecht.
Amsterdam UMC, locatie AMC, afd. Nefrologie, Amsterdam.
Ned Tijdschr Geneeskd. 2020 Apr 20;164:D4337.
Available treatment options for patients with end-stage kidney disease are kidney transplantation, haemodialysis, peritoneal dialysis or refraining from renal replacement therapy (conservative treatment). Haemodialysis removes uremic toxins and fluid by passing blood via vascular access through an artificial kidney for 4 hours 3 times a week on average. Peritoneal dialysis (PD) removes uremic toxins and fluid through the peritoneum by instillation and drainage of a special fluid via a PD catheter in and out of the abdominal cavity a number of times a day. Peritoneal dialysis is performed at home, while haemodialysis is performed at a hospital or dialysis centre, but can also be performed at home. Both forms of dialysis have significant impact on patients' quality of life and each have their own specific complications. These are mainly problems with vascular access and intradialytic hypotension in the case of haemodialysis, while the occurrence of peritonitis and membrane failure are those of peritoneal dialysis.
终末期肾病患者可用的治疗选择包括肾移植、血液透析、腹膜透析或不进行肾脏替代治疗（保守治疗）。血液透析通过血管通路将血液输送至人工肾，平均每周3次，每次4小时，以此清除尿毒症毒素和液体。腹膜透析通过经腹膜透析导管向腹腔内注入并引流一种特殊液体，每天多次进出腹腔，从而通过腹膜清除尿毒症毒素和液体。腹膜透析在家庭中进行，而血液透析在医院或透析中心进行，但也可在家中进行。两种透析方式都会对患者的生活质量产生重大影响，且各自都有特定的并发症。血液透析的主要并发症是血管通路问题和透析过程中的低血压，而腹膜透析的并发症是腹膜炎和腹膜失功。
