ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2013, Vol. 22 ›› Issue (5): 422-426.

• 论文 • 上一篇    下一篇

腹膜透析联合血液透析治疗终末期肾病

  

  • 出版日期:2013-10-28 发布日期:2013-10-28

Clinical experiences of peritoneal dialysis combined with hemodialysis treatment in patients with ESRD

  • Online:2013-10-28 Published:2013-10-28

摘要:

摘要  目的:探讨腹膜透析联合血液透析(peritoneal dialysis and hemodialysis,PHD)治疗腹透欠充分的终末期肾病(end stage renal disease,ESRD)患者的临床经验。方法:回顾性分析本中心11例腹透不充分的ESRD患者改用PHD联合治疗后的临床疗效。随访观察患者的一般临床表现;透析充分性;营养指标;降压药的使用情况。结果:本组患者男:女=8:3。透析时年龄:50.6±16.5(23~74岁)。原发病:9例(81.8%)为慢性肾小球肾炎,2例(18.2%)为糖尿病肾病。PHD前的平均腹膜透析(peritoneal dialysis,PD)治疗时间:3.1±1.2(1.2~4.4)年。经过PHD治疗后患者的食欲改善;饮食限制减少;所有患者的不安腿症状得以改善;皮肤瘙痒不同程度减轻。小分子物质清除率增加,每周尿素Kt/V 由1.54±0.2增加至1.96±0.4 L/Week.1.73m2(P<0.05)。血浆白蛋白(Alb)由39.4±4.1升高至40.7±3.8g/L(P>0.05);血红蛋白(Hb)由8.6±1.0升高至9.6±1.3g/dl(P<0.05)。结论:PHD可以提高透析充分性,改善患者的临床症状和营养状态。PHD可以作为一种新的肾脏替代治疗模式在临床推广。

关键词: 关键词 , 腹膜透析联合血液透析;终末期肾病;残余肾功能

Abstract:

Objective: To determine the clinical experience of using combined modality-simultaneous peritoneal dialysis (PD) and hemodialysis (HD) treatment in patients with end-stage renal disease (ESRD). Methodology: Eleven patients on PD and diagnosed with underdialysis and/or overhydration with declining RRF were recruited in this retrospective study. Parameters of volume control, and uremic solute removal were collected. Results: They were 8 males, 3 females, with a mean age of 50.6±16.5 years old at the start of combined therapy. Mean duration of PD at the start of combined therapy was 3.1±1.2(1.2~4.4)years. Their underlying kidney diseases were 9 casses of chronic glomerulonephritis and 2 cases of diabetic nephropathy. The weekly Kt/V urea increased to 1.96±0.4 from 1.54±0.2L/Week.1.73m2 (p< 0.05). The patients’ hydration status improved significantly with reductions in blood pressure. The hemoglobin level was increased remarkably from 8.6±1.0 to 9.6±1.3g/dl (p < 0.05) even though at the same time the dose of recombinant human erythropoietin decreased significantly. The level of serum albumin was also increased after concomitant HD use. Conclusion: PD and Hemodialysis are not mutually exclusive. They can be used in combination to achieve targeted solute clearances, to improve certain clinical conditions and nutrition status.

Key words: Key Words: Combination Therapy with Hemodialysis and Peritoneal Dialysis, End stage renal diasease, Residual renal function