Division of Nephrology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.
J Nephrol. 2020 Dec;33(6):1189-1194. doi: 10.1007/s40620-020-00787-0. Epub 2020 Jul 11.
Kidney transplantation offers the best potential for full rehabilitation in patients with end-stage kidney disease who are treated with dialysis. However, due to organ shortage which is a universal phenomenon, most patients need to be maintained on a period of dialysis therapy before the prospect of transplantation. Peritoneal dialysis (PD) could be an ideal form of renal replacement therapy due to its favorable profile toward preservation of residual renal function, patient survival, lower overall burden on cardiovascular morbidity and infection risks.
With extensive experience in PD therapy from Hong Kong where PD-first is a mandatory health policy, we reviewed the literature and present current evidence that favors PD as an optimal form of bridging renal replacement therapy prior to kidney transplantation.
PD provides a viable and advantageous form of renal reaplcement particularly in terms of preservation of residual renal function, patient survival and quality of life, and cost among many other factors. Potential misconceptions that PD-related peritonitis and dialysis inadequacy are potentially deterrent factors for initiating PD therapy are clarified.
PD is a practical and noninferior form of renal replacement that serves as an ideal bridge from conservative therapy to kidney transplantation.
对于接受透析治疗的终末期肾病患者，肾移植提供了全面康复的最佳潜力。然而，由于器官短缺是普遍现象，大多数患者在接受移植之前需要进行一段时间的透析治疗。腹膜透析（PD）由于其对保留残余肾功能、患者生存、降低心血管发病率和感染风险的整体负担具有有利的特征，因此可能是一种理想的肾脏替代治疗形式。
我们在香港拥有丰富的 PD 治疗经验，PD 优先是强制性的卫生政策，我们查阅了文献并提供了目前支持 PD 作为肾移植前最佳桥接肾脏替代治疗形式的证据。
PD 提供了一种可行且有利的肾脏替代形式，特别是在保留残余肾功能、患者生存和生活质量以及成本等方面。澄清了 PD 相关腹膜炎和透析不足可能是开始 PD 治疗的潜在障碍的误解。
PD 是一种实用且不劣于其他形式的肾脏替代治疗方法，是从保守治疗到肾移植的理想桥梁。
