关键词: 腹膜透析 , 急性肾损伤 , 局灶节段肾小球硬化症

Abstract:

Objective: To observe the efficacy and safety of peritoneal dialysis (PD) in the treatment of focal segmental glomerular sclerosis (FSGS) patients with acute kidney injury (AKI).  Methodology: Nineteen FSGS patients with AKI were enrolled in this study. They received DAPD with a daily exchange of 1 ~ 8L for at least 3 months. The clinical outcome, peritoneal dialysis related complications, and biochemical parameters were reviewed.  Results: The patients had a mean follow-up of more than 3 months. The mean time of PD treatment was (5.0±2.9) months (range 2 to 10 months). 10 (52.7%) of the 19 cases got a normal renal function, 9 cases got rid of dialysis, 1 switched to hemodialysis. More than 70% of patients had satisfying volume and blood pressure control. At the end of follow-up, Serum creatinine decreased to 65.6% of baseline (P >0.05) and BUN decreased to 47.9% of baseline (P <0.01). Patients also had increased serum albumin, pre-albumin and urine output, and decreased proteinuria, urine NAG and RBP. Edema usually subsided within 4 weeks of PD therapy and the mean time of renal function recovery was (3.7±1.6) months (range 1 to 6 months). PD-related complications occurred in 8 cases (42.0%), including 5 cases of peritonitis, 1 catheter exit site infection, 1 case of poor dialysate drainage and 1 dialysate leakage to the thoracic cavity. No clinically significant complications such as perivascular effusion and abdominal organ damage were noted.24 hours peritoneal protein losses was 0.73g/L.  Conclusions: Due to its efficacy and less adverse events, short-term PD can be used as an effective auxiliary treatment for nephrotic syndrome (NS) with AKI, especially for those who presented with severe edema and massive ascites, and for those who had poor response to diuretics.

Key words: peritoneal dialysis , acute kidney injury , focal segmental glomerular sclerosis