Catizone L, Cocchi R, Fusaroli M, Zucchelli P
Department of Nephrology and Dialysis, Malpighi Hospital, Bologna, Italy.
Perit Dial Int. 1993;13 Suppl 2:S523-6.
To evaluate whether the continuous ambulatory peritoneal dialysis (CAPD) technique is able per se to obtain lower beta 2-microglobulin (beta 2M) plasma levels than hemodialysis (HD) or whether other factors, such as residual diuresis, can make a significant contribution, we compared 69 CAPD and 38 cuprophan HD patients, matched for age and dialysis duration. Residual diuresis was 680.3 +/- 531.8 mL/day in CAPD and 285.5 +/- 381.8 mL/day in HD (p < 0.001) subjects. Daily diuresis was > 300 mL/day in 63.8% of CAPD and in 31.6% of HD patients. The beta 2M plasma levels were 26.3 +/- 9.9 mg/L and 34.9 +/- 13.3 mg/L (p < 0.001) in CAPD and HD, respectively. In both groups the difference was significant when we compared the patients with diuresis below versus above 300 mL/day (p < 0.001). Instead, the differences were not significant upon comparing the CAPD and HD patients with the same amount of daily diuresis. The comparison between beta 2M plasma levels and residual diuresis showed a significant inverse correlation in both groups (p < 0.001). We conclude that the dialysis technique itself does not affect beta 2M plasma levels. The diuresis volume may be a very important factor in lowering beta 2M levels in both CAPD and HD patients. CAPD's capacity to maintain a higher diuresis for longer than HD may account for the lower beta 2M plasma levels in CAPD patients.
为了评估持续性非卧床腹膜透析（CAPD）技术本身是否能够比血液透析（HD）获得更低的血浆β2-微球蛋白（β2M）水平，或者其他因素，如残余尿量，是否能起到显著作用，我们比较了69例CAPD患者和38例铜仿膜HD患者，这些患者在年龄和透析时间上相匹配。CAPD患者的残余尿量为680.3±531.8 mL/天，HD患者为285.5±381.8 mL/天（p<0.001）。63.8%的CAPD患者和31.6%的HD患者每日尿量>300 mL/天。CAPD组和HD组的血浆β2M水平分别为26.3±9.9 mg/L和34.9±13.3 mg/L（p<0.001）。在两组中，当我们比较尿量低于和高于300 mL/天的患者时，差异均具有显著性（p<0.001）。相反，比较每日尿量相同的CAPD和HD患者时，差异不显著。血浆β2M水平与残余尿量之间的比较显示，两组均存在显著的负相关（p<0.001）。我们得出结论，透析技术本身并不影响血浆β2M水平。尿量可能是降低CAPD和HD患者β2M水平的一个非常重要的因素。CAPD比HD更能长时间维持较高尿量的能力，可能是CAPD患者血浆β2M水平较低的原因。
