Nand N, Mahajan S K, Wig N, Sharma M, Aggarwal H K, Seth R K
Dept of Medicine, Pt. B.D.S., Postgraduate Institute of Medical Sciences Rohtak.
J Assoc Physicians India. 1996 Nov;44(11):780-3.
Thirty patients of acute or acute on chronic renal failure (ACRF) were randomly divided into two group of 15 cases each. Group A patients received 36 cycles of intermittent peritoneal dialysis (PD) with an exchange volume of one litre and duration of one hour per cycle. The 36 cycles of PD were divided into 12 clearance periods of 3 cycles each. Sodium Nitroprusside (SNP) was added in a dose of 4 mg/litre of dialysate in alternate clearance periods. Group B patients were given 4 hours of haemodialysis (HD) to compare the efficacy of two modes of dialysis. Symptomatic relief was observed in various uraemic signs and symptoms like vomiting, level of consciousness, fluid overload, hiccough and asterexis in most of the patients in both the groups. The percentage fall in blood urea and serum creatinine was 57.02 Vs 58.04 mg% and 46.9 Vs 47.8 mg% in group A and B respectively (P 70.5 each). Total dialysate urea removal following PD and HD was 118.8 +/- 57.3 gm and 98.5 +/- 37.0 gm respectively and also there was no significant difference in total creatinine removal. No untoward effects were observed with PD. However, following HD, 5 patients developed hypotension, supraventricular tachycardia was observed in one and disequilibrium syndrome in 8 of them. Therefore, it can be concluded that SNP added PD is comparable to 4 hours of haemodialysis both clinically as well as biochemically and in situations where facilities for HD do not exist or it is contraindicated, PD may be preferred mode of therapy.
30例急性或慢性肾衰竭急性加重（ACRF）患者被随机分为两组，每组15例。A组患者接受36个周期的间歇性腹膜透析（PD），每次交换量为1升，每个周期持续1小时。这36个周期的PD被分为12个清除期，每个清除期3个周期。在交替的清除期，每升透析液中加入4毫克硝普钠（SNP）。B组患者接受4小时的血液透析（HD），以比较两种透析方式的疗效。两组大多数患者的各种尿毒症体征和症状，如呕吐、意识水平、液体超负荷、呃逆和扑翼样震颤等均有症状缓解。A组和B组血尿素和血清肌酐的下降百分比分别为57.02对58.04毫克%和46.9对47.8毫克%（每组P>0.5）。PD和HD后透析液总尿素清除量分别为118.8±57.3克和98.5±37.0克，肌酐总清除量也无显著差异。PD未观察到不良反应。然而，HD后，5例患者出现低血压，1例出现室上性心动过速，8例出现失衡综合征。因此，可以得出结论，添加SNP的PD在临床和生化方面与4小时血液透析相当，在不存在HD设备或HD禁忌的情况下，PD可能是首选的治疗方式。
