Auguste Bourne L, Bargman Joanne M
Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Toronto General Hospital, Toronto, Ontario, Canada.
Am J Kidney Dis. 2023 Jan;81(1):100-109. doi: 10.1053/j.ajkd.2022.07.004. Epub 2022 Oct 5.
As the global prevalence of peritoneal dialysis (PD) continues to grow, practitioners must be equipped with prescribing strategies that focus on the needs and preferences of patients. PD is an effective form of kidney replacement therapy that offers numerous benefits to patients, including more flexibility in schedules compared with in-center hemodialysis (HD). Additional benefits of PD include salt and water removal without significant changes in patient hemodynamics. This continuous yet gentle removal of solutes and fluid is associated with better-preserved residual kidney function. Unfortunately, sometimes these advantages are overlooked at the expense of an emphasis on achieving small solute clearance targets. A more patient-centered approach emphasizes the importance of individualized treatment, particularly when considering incremental PD and other prescriptions that align with lifestyle preferences. In shifting the focus from small solute clearance targets to patient needs and clinical goals, PD remains an attractive, patient-centered form of kidney replacement therapy.
随着全球腹膜透析（PD）的患病率持续上升，从业者必须具备以患者需求和偏好为重点的处方策略。腹膜透析是一种有效的肾脏替代疗法，为患者带来诸多益处，包括与中心血液透析（HD）相比，日程安排更具灵活性。腹膜透析的其他益处包括在不显著改变患者血流动力学的情况下清除盐分和水分。这种持续且温和的溶质和液体清除方式与更好地保留残余肾功能相关。不幸的是，有时这些优势被忽视，而以强调实现小分子溶质清除目标为代价。一种更以患者为中心的方法强调个体化治疗的重要性，特别是在考虑增量腹膜透析和其他符合生活方式偏好的处方时。在将重点从小分子溶质清除目标转向患者需求和临床目标的过程中，腹膜透析仍然是一种有吸引力的、以患者为中心的肾脏替代疗法。
