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血液透析与腹膜透析治疗终末期肾病的效果比较

Comparison of the effect of hemodialysis and peritoneal dialysis in the treatment of end-stage renal disease.

作者信息

Zhao Yuan

机构信息

Yuan Zhao Department of Nephrology, The First People's Hospital of Tonglu County, Tonglu, Hangzhou City 311500, Zhejiang Province, P.R. China.

出版信息

Pak J Med Sci. 2023 Nov-Dec;39(6):1562-1567. doi: 10.12669/pjms.39.6.8056.

DOI:10.12669/pjms.39.6.8056
PMID:37936738
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10626077/
Abstract

OBJECTIVE

To compare the clinical effects of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of end-stage renal disease (ESRD) patients.

METHODS

Clinical data of ESRD patients who received HD (n=74) and PD (n=77) for more than 12 months in the First People's Hospital of Tonglu County from October 2020 to November 2021 were retrospectively selected. Renal function indexes, blood pressure, and complication rates in the two groups before the first dialysis and at the end of the observation period were compared.

RESULTS

After the dialysis, the urea nitrogen (BUN) levels decreased in both groups, and were significantly lower in the PD group compared to the HD group. Urea clearance index (Kt/V) increased, and were significantly higher in the PD group compared to the HD group (<0.05). After the dialysis, albumin (ALB) and cardiac ejection fraction (EF) levels significantly increased, and ALB levels were significantly higher in the HD group while EF levels were significantly higher in the PD group (<0.05). Levels of whole parathyroid hormone (iPTH), systolic blood pressure, and diastolic blood pressure indicators in both groups decreased compared to before the dialysis, and were significantly lower in the PD group compared to the HD group of patients (<0.05). PD was associated with significantly lower total incidence of complications compared to HD (<0.05).

CONCLUSIONS

Peritoneal dialysis is more effective in maintaining the hemodynamic stability for ESRD patients, reducing blood pressure level, improving the clearance rate of molecular substances, and protecting the renal function of patients compared to hemodialysis.

摘要

目的

比较血液透析(HD)和腹膜透析(PD)治疗终末期肾病(ESRD)患者的临床效果。

方法

回顾性选取2020年10月至2021年11月在桐庐县第一人民医院接受HD(n = 74)和PD(n = 77)治疗超过12个月的ESRD患者的临床资料。比较两组首次透析前及观察期末的肾功能指标、血压及并发症发生率。

结果

透析后,两组尿素氮(BUN)水平均下降,且PD组显著低于HD组。尿素清除指数(Kt/V)升高,且PD组显著高于HD组(<0.05)。透析后,白蛋白(ALB)和心脏射血分数(EF)水平显著升高,HD组ALB水平显著更高,而PD组EF水平显著更高(<0.05)。两组全段甲状旁腺激素(iPTH)、收缩压和舒张压指标较透析前均下降,且PD组患者显著低于HD组(<0.05)。与HD相比,PD的并发症总发生率显著更低(<0.05)。

结论

与血液透析相比,腹膜透析在维持ESRD患者血流动力学稳定性、降低血压水平、提高分子物质清除率及保护患者肾功能方面更有效。

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