Hiroshige K, Yuu K, Soejima M, Takasugi M, Kuroiwa A
Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu City, Japan.
Perit Dial Int. 1996 May-Jun;16(3):307-15.
To determine the effect of peritoneal dialysis modalities such as nightly intermittent peritoneal dialysis (NIPD), continuous cyclic peritoneal dialysis (CCPD), and continuous ambulatory peritoneal dialysis (CAPD) on residual renal function.
A six-month prospective, nonrandomized comparison study.
Outpatient CAPD unit of a university hospital.
Eighteen end-stage renal disease patients treated by peritoneal dialysis (8 by NIPD, 5 by CCPD, and 5 by CAPD).
Samples from the total dialysate, blood, and 24-hour urine collection were obtained monthly.
Urea, creatinine, and beta2-microglobulin concentrations were measured. Renal and peritoneal clearances of each substance and KT/V urea were calculated. Residual renal function (RRF) was estimated by renal creatinine clearance (RCcr).
No significant differences in age, sex, and primary renal disease among the three groups were noted. In all groups, anemic and hypertensive states were controlled identically, and mean weekly total (renal + peritoneal) KT/V urea (over 2.1/wk) and total creatinine clearance (over 60 L/wk/1.73 m2) were maintained during the whole experimental period. Starting mean RCcr was near 4.0 mL/min/1.73 m2 in all groups. Thereafter, a rapid and significant decline in RRF was demonstrated on NIPD and CCPD. The declining rates of RCcr values at 6 months after starting NIPD and CCPD were -0.29 and -0.34 mL/min/month, respectively, which were much greater than those of CAPD (+0.01 mL/min/month).
Because of a possibly characteristic progressive loss of RRF in automated peritoneal dialysis (APD), strict regular assessment of RRF should be performed from the start of APD.
确定夜间间歇性腹膜透析（NIPD）、持续循环腹膜透析（CCPD）和持续非卧床腹膜透析（CAPD）等腹膜透析方式对残余肾功能的影响。
一项为期六个月的前瞻性、非随机对照研究。
某大学医院的门诊CAPD病房。
18例接受腹膜透析治疗的终末期肾病患者（8例接受NIPD治疗，5例接受CCPD治疗，5例接受CAPD治疗）。
每月采集总透析液、血液和24小时尿液样本。
测量尿素、肌酐和β2-微球蛋白浓度。计算每种物质的肾脏和腹膜清除率以及KT/V尿素。通过肾脏肌酐清除率（RCcr）评估残余肾功能（RRF）。
三组患者在年龄、性别和原发性肾脏疾病方面无显著差异。在所有组中，贫血和高血压状态得到相同控制，并且在整个实验期间维持平均每周总（肾脏+腹膜）KT/V尿素（超过2.1/周）和总肌酐清除率（超过60 L/周/1.73 m2）。所有组开始时的平均RCcr接近4.0 mL/分钟/1.73 m2。此后，NIPD和CCPD组的RRF迅速且显著下降。开始NIPD和CCPD治疗6个月后RCcr值的下降速率分别为-0.29和-0.34 mL/分钟/月，远大于CAPD组（+0.01 mL/分钟/月）。
由于自动腹膜透析（APD）中RRF可能存在特征性的进行性丧失，应从APD开始就严格定期评估RRF。
