Rodríguez A M, Díaz N V, Cubillo L P, Plana J T, Riscos M A, Delgado R M, Herrera C M, Ribes E A, Molina F T, Heras M M, González A T, Cantón C G, Fernández A R, Laborda E B, Zurita M N, Girón F F, Santana P S
Service of Nephrology, Hospital Nuestra Señora del Pino, Las Palmas de Gran Canaria, Spain.
Nephrol Dial Transplant. 1998 Sep;13(9):2335-40. doi: 10.1093/ndt/13.9.2335.
A prospective sequential study on continuous ambulatory peritoneal dialysis (CAPD) and three techniques of automated peritoneal dialysis (APD) was conducted to assess peritoneal clearances, the influence of peritoneal permeability on nocturnal APD clearances and the suitability of the peritoneal equilibration test (PET) for predicting clearances on APD.
After performing a PET, a series of clinical, biochemical and dialysis adequacy markers were evaluated after 2 months on CAPD, continuous cycling peritoneal dialysis (CCPD) and tidal volume peritoneal dialysis (TPD) with 50% and 25% tidal volumes. Forty five patients participated and 33 completed the study.
Serum urea and creatinine decreased significantly whereas haemoglobin and glucose increased. Mean peritoneal urea clearance (1/week) was 55.40+/-8.76 on CAPD, 74.82+/-12.62 on CCPD, 69.20+/-14.63 on TPD (tidal 50%) and 66.89+/-13.23 on TPD (tidal 25%); mean creatinine clearance (1/week/1.73 m2) was 42.80 +/- 9.95, 52.19 +/- 11.11, 51.31 +/- 13.3 and 49.17 +/- 11.83, respectively. Both clearances were significantly lower on CAPD than on APD (P<0.001). CCPD was the automated technique that provided the best nocturnal urea clearance (P<0.01). Nocturnal creatinine clearance did not show significant differences between CCPD and TPD (tidal 50%), being better with both techniques than with TPD (tidal 25%). There were statistically significant differences between nocturnal dialysate to plasma (D/P) ratios and those corresponding to the nearest times in the PET. The urea D/P ratio at 180 min and the creatinine D/P ratio at 240 min of the PET were the parameters that better estimated nocturnal clearances on APD.
This study confirms that TPD does not improve the results of CCPD. Significant differences between D/P ratios during actual nocturnal cycles and PETs were observed.
开展了一项关于持续性非卧床腹膜透析（CAPD）和三种自动化腹膜透析（APD）技术的前瞻性序贯研究，以评估腹膜清除率、腹膜通透性对夜间APD清除率的影响以及腹膜平衡试验（PET）预测APD清除率的适用性。
进行PET后，在CAPD、持续循环腹膜透析（CCPD）以及潮气量为50%和25%的潮式腹膜透析（TPD）治疗2个月后，评估一系列临床、生化和透析充分性指标。45名患者参与研究，33名完成研究。
血清尿素和肌酐显著降低，而血红蛋白和血糖升高。CAPD时平均腹膜尿素清除率（每周）为55.40±8.76，CCPD时为74.82±12.62，TPD（潮气量50%）时为69.20±14.63，TPD（潮气量25%）时为66.89±13.23；平均肌酐清除率（每周/1.73平方米）分别为42.80±9.95、52.19±11.11、51.31±13.3和49.17±11.83。CAPD的两种清除率均显著低于APD（P<0.001）。CCPD是提供最佳夜间尿素清除率的自动化技术（P<0.01）。CCPD和TPD（潮气量50%）之间的夜间肌酐清除率无显著差异，这两种技术的夜间肌酐清除率均优于TPD（潮气量25%）。夜间透析液与血浆（D/P）比值与PET中最接近时间的比值之间存在统计学显著差异。PET中180分钟时的尿素D/P比值和240分钟时的肌酐D/P比值是更好地估计APD夜间清除率的参数。
本研究证实TPD并不能改善CCPD的结果。观察到实际夜间循环期间和PET期间D/P比值之间存在显著差异。
