Madden M A, Zimmerman S W, Simpson D P
Clin Nephrol. 1981 Dec;16(6):293-9.
Twelve patients who had been on intermittent peritoneal dialysis (IPD) for an average of 18.3 months each, were switched to continuous ambulatory peritoneal dialysis (CAPD). CAPD experience is now 118 patient months (average 9.8 months per patient), and ten patients remain on CAPD. Serum chemistries reflected the change to continuous dialysis with a fall in serum creatinine, potassium, uric acid, phosphate, and BUN. The total CO2 rose markedly, indicating prevention of the recurrent metabolic acidosis experienced in IPD. Serum phosphate fell significantly into the normal range. Serum calcium rose slightly in six patients and significantly in three others. Serum alkaline phosphatase activity rose in seven patients, without development of clinical evidence of bone disease. Mean hematocrit values were higher in most patients of CAPD, but fell again after one year. The transient nature of the rise in hematocrit suggests that improved volume control, as reflected in blood pressure changes, may play a role in the frequently reported increase in hematocrit on CAPD. Despite an increase in peritonitis rate (one infection per 5.9 patient months on CAPD, versus one per 12.2 patient months on IPD), CAPD offers several distinct advantages over IPD, especially in control of uremic acidosis, phosphate retention, blood pressure and fluid management, as well as an overall improvement in physical and psychosocial well-being.
12名平均接受间歇性腹膜透析（IPD）18.3个月的患者转为持续性非卧床腹膜透析（CAPD）。目前CAPD的经验为118个患者月（平均每位患者9.8个月），10名患者仍在接受CAPD治疗。血清化学指标反映了向持续性透析的转变，血清肌酐、钾、尿酸、磷酸盐和尿素氮下降。总二氧化碳显著升高，表明预防了IPD中出现的反复代谢性酸中毒。血清磷酸盐显著下降至正常范围。6名患者的血清钙略有升高，另外3名患者的血清钙显著升高。7名患者的血清碱性磷酸酶活性升高，但未出现骨病的临床证据。大多数CAPD患者的平均血细胞比容值较高，但1年后再次下降。血细胞比容升高的短暂性表明，血压变化所反映的容量控制改善可能在CAPD中经常报道的血细胞比容升高中起作用。尽管腹膜炎发生率有所增加（CAPD为每5.9个患者月发生1次感染，IPD为每12.2个患者月发生1次感染），但与IPD相比，CAPD具有几个明显的优势，尤其是在控制尿毒症酸中毒、磷酸盐潴留、血压和液体管理方面，以及在整体身体和心理社会幸福感方面的改善。
