Lutes R, Perlmutter J, Holley J L, Bernardini J, Piraino B
Renal-Electrolyte Division, University of Pittsburgh, Pennsylvania.
Adv Perit Dial. 1993;9:165-8.
We performed a retrospective chart review of 32 patients on peritoneal dialysis (PD) for longer than 5 months (range 5-64 months) in an attempt to identify risk factors influencing the preservation of renal function. Residual renal function (RRF) was evaluated by measurement of creatinine clearance (Ccr) from 24-hour urine collections. Risk factors examined included age and Ccr at start of PD, presence of diabetes, mean arterial pressure (MAP), diastolic blood pressure (DBP), and peritonitis rate. Multiple regression analysis was performed to determine the correlation of these factors to the rate of decline of Ccr. Loss of RRF in all patients was 0.3 mL/min/month (median 0.2, range 0.04-1.7). The contribution of RRF to total Ccr was 39% (range 12%-72.5%). Patient age, presence of diabetes, MAP, DBP, peritonitis rate, and Ccr at the start of PD had no influence on the rate of RRF loss. Nine patients in the study (28%) had been on PD longer than 2 years and still had significant renal function (mean Ccr 3.3 mL/min), which was 40% of their total weekly Ccr. These results show that PD patients can maintain RRF for extended periods and that RRF contributes substantially to their weekly Ccr. The risk factors evaluated did not influence the rate of renal function loss.
我们对32例接受腹膜透析（PD）超过5个月（范围为5 - 64个月）的患者进行了回顾性病历审查，以确定影响肾功能保留的危险因素。通过测量24小时尿液收集的肌酐清除率（Ccr）来评估残余肾功能（RRF）。所检查的危险因素包括PD开始时的年龄和Ccr、糖尿病的存在、平均动脉压（MAP）、舒张压（DBP）和腹膜炎发生率。进行多元回归分析以确定这些因素与Ccr下降率的相关性。所有患者的RRF损失为0.3 mL/分钟/月（中位数0.2，范围0.04 - 1.7）。RRF对总Ccr的贡献为39%（范围12% - 72.5%）。患者年龄、糖尿病的存在、MAP、DBP、腹膜炎发生率以及PD开始时的Ccr对RRF损失率没有影响。该研究中的9例患者（28%）接受PD治疗超过2年，仍具有显著的肾功能（平均Ccr为3.3 mL/分钟），占其每周总Ccr的40%。这些结果表明，PD患者可以长时间维持RRF，并且RRF对其每周的Ccr有很大贡献。所评估的危险因素并未影响肾功能丧失的速率。
