Twardowski Z, Ksiazek A, Majdan M, Janicka L, Bocheńska-Nowacka E, Sokołowska G, Gutka A, Zbikowska A
Clin Nephrol. 1981 Mar;15(3):119-30.
Fourteen patients who had no signs of peritonitis were studied during CAPD. Different exchange time schedules were used alternating exchanges with 1.5% and 2.6% glucose solutions. Usually longer exchanges followed shorter ones and vice versa. Total exchange time varied from 2--10 hours. Maximal ultrafiltration volumes were observed after 3 hours with 1.5% and 5 hours wit 2.6% glucose solutions. For small molecular weight solutes (urea, creatinine, sodium, potassium, and phosphate) dialyzate to plasma concentration ratios tended to be lower with 2.6% glucose solutions during the shorter exchanges. Equilibrium between plasma and dialyzate was attained for all these solutes by 10 hours total exchange time. The concentration ratios for inulin were similar with both types of solution, and did not achieve equilibrium by 10 hours. Protein concentrations and losses were higher with 2.6% glucose solution. Total protein and immunoglobulin losses per 24 hours were markedly lower than those reported for intermittent peritoneal dialysis. White blood cell counts increased slightly up to 5 hours and then remained constant up to 10 hours. Mononuclear cell counts were consistently higher than those of granulocytes. The efficiency of dialysis was not markedly influenced by uneven distribution of total exchange time. If 1.5% and 2.6% glucose solutions were used for particular time schedules, slightly higher dialysis efficiency could be obtained by using hyperosmolar solutions for the longer exchanges. Ultrafiltration volumes, protein and immunoglobulin losses, cell counts in dialyzate, and clearance of inulin varied among individual patients. Protein losses correlated positively with serum protein concentration and the body surface area of the patient. Clearances of insulin also correlated with body surface area but ultrafiltration volumes did not.
对14例无腹膜炎体征的患者进行持续性非卧床腹膜透析（CAPD）研究。采用不同的换液时间方案，交替使用1.5%和2.6%的葡萄糖溶液进行换液。通常较长时间的换液之后是较短时间的换液，反之亦然。总换液时间为2至10小时。使用1.5%葡萄糖溶液时，3小时后观察到最大超滤量；使用2.6%葡萄糖溶液时，5小时后观察到最大超滤量。对于小分子溶质（尿素、肌酐、钠、钾和磷酸盐），在较短时间的换液过程中，2.6%葡萄糖溶液的透析液与血浆浓度比往往较低。到总换液时间10小时时，所有这些溶质在血浆和透析液之间达到平衡。两种溶液的菊粉浓度比相似，且到10小时时未达到平衡。2.6%葡萄糖溶液的蛋白质浓度和损失更高。每24小时的总蛋白和免疫球蛋白损失明显低于间歇性腹膜透析报告的损失。白细胞计数在5小时内略有增加，然后在10小时内保持稳定。单核细胞计数始终高于粒细胞计数。透析效率并未受到总换液时间分布不均的明显影响。如果在特定的时间方案中使用1.5%和2.6%的葡萄糖溶液，通过在较长时间的换液中使用高渗溶液可获得略高的透析效率。超滤量、蛋白质和免疫球蛋白损失、透析液中的细胞计数以及菊粉清除率在个体患者之间存在差异。蛋白质损失与血清蛋白浓度和患者体表面积呈正相关。胰岛素清除率也与体表面积相关，但超滤量与体表面积无关。
