自动化腹膜透析中通过超滤去除钠的量在儿科患者中的应用。

Sodium removal per ultrafiltration volume in automated peritoneal dialysis in pediatric patients.

机构信息

Department of Nephrology and Rheumatology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.

Department of Pediatrics, Naha City Hospital, Okinawa, Japan.

出版信息

Pediatr Nephrol. 2024 Sep;39(9):2753-2758. doi: 10.1007/s00467-024-06383-9. Epub 2024 May 2.

DOI:10.1007/s00467-024-06383-9

PMID:38695892

Abstract

BACKGROUND

The standard rate of sodium removal in adult anuric patients on continuous ambulatory peritoneal dialysis (CAPD) is 7.5 g/L of ultrafiltration volume (UFV). Although automated PD (APD) is widely used in pediatric patients, no attempt has yet been made to estimate sodium removal in APD.

METHODS

The present, retrospective cohort study included pediatric patients with APD who were managed at Tokyo Metropolitan Children's Medical Center between July 2010 and November 2017. The patients underwent a peritoneal equilibrium test (PET) at our hospital. Sodium removal per UFV was calculated by peritoneal function and dwell time using samples from patients on APD with 1- and 2-h dwell effluent within three months of PET and 4- and 10-h dwell effluent at PET.

RESULTS

In total, 217 samples from 18 patients were included, with 63, 81, and 73 of the samples corresponding to the High [H], High-average [HA], and Low-average [LA] PET category, respectively. Sodium removal per UFV (g/L in salt equivalent) for dwell times of one, two, four, and ten hours was 5.2, 8.8, 8.0, and 11.5 for PET [H], 5.3, 5.8, 5.6, and 8.1 for PET [HA], and 4.6, 5.1, 5.1, and 7.1 for PET [LA], respectively.

CONCLUSIONS

Sodium removal per UFV in pediatric APD was less than the standard adult CAPD and tended to be lower with shorter dwell times, leading to sodium accumulation. Therefore, salt intake should be restricted in combination with one or more long daytime dwells, especially in anuric patients.

摘要

背景

成人无尿患者在持续性不卧床腹膜透析（CAPD）中标准的钠清除率为超滤量（UFV）的 7.5g/L。尽管自动化腹膜透析（APD）在儿科患者中广泛应用，但尚未尝试估计 APD 中的钠清除率。

方法

本回顾性队列研究纳入了 2010 年 7 月至 2017 年 11 月期间在东京都儿童医疗中心接受 APD 治疗的儿科患者。患者在我院进行了腹膜平衡试验（PET）。通过对在 PET 后三个月内进行的 1 小时和 2 小时腹腔留置液样本以及在 PET 时进行的 4 小时和 10 小时腹腔留置液样本，利用腹膜功能和留置时间，计算出每个 UFV 的钠清除量。

结果

共纳入了 18 例患者的 217 个样本，其中 63、81 和 73 个样本分别对应于高（H）、高平均（HA）和低平均（LA）PET 类别。在 PET [H]时，1 小时、2 小时、4 小时和 10 小时的 UFV 钠清除量（以盐当量计，g/L）分别为 5.2、8.8、8.0 和 11.5，在 PET [HA]时，1 小时、2 小时、4 小时和 10 小时的 UFV 钠清除量分别为 5.3、5.8、5.6 和 8.1，在 PET [LA]时，1 小时、2 小时、4 小时和 10 小时的 UFV 钠清除量分别为 4.6、5.1、5.1 和 7.1。