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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (5): 427-434.DOI: 10.3969/j.issn.1006⁃298X.2025.05.005

• 论著 • 上一篇    下一篇

沙库巴曲缬沙坦对持续性非卧床腹膜透析患者残余肾功能的影响

  

  • 出版日期:2025-10-28 发布日期:2025-10-30

Sacubitril⁃valsartan on residual renal function in patients undergoing continuous ambulatory peritoneal dialysis

  • Online:2025-10-28 Published:2025-10-30

摘要: 目的:探讨沙库巴曲缬沙坦对持续性非卧床腹膜透析(CAPD)患者残余肾功能的影响。方法:回顾性分析安徽中医药大学第一附属医院肾内科随访的 CAPD 患者资料,根据是否口服沙库巴曲缬沙坦分为观察组(34 例)和对照组(38 例),观察时间 12 个月。收集两组患者一般资料、血生化、残余肾功能指标(24h 残余尿量、残余肾尿素清除指数 Kt/V、残余肾肾小球滤过率 GFR)、腹膜 Kt/V、总 Kt/V、左室射血分数(LVEF)、脑利钠肽(BNP),记录不良反应。结果:两组基线临床指标无统计学差异。随访 12 个月后,两组残余肾功能指标均下降,除残余肾 Kt/V 外,其余指标均有显著组别 × 时间交互作用(P 交互 < 0.05);观察组残余肾 Kt/V 显著高于对照组(P=0.041)。心功能方面,LVEF 有显著交互作用(P 交互 = 0.005),BNP 观察组显著低于对照组(P<0.001)。血生化指标中,血清甲状旁腺激素和血磷有显著交互作用(P 交互 < 0.01),12 个月后观察组值显著低于对照组。观察组干咳 2 例(5.9%),对照组血管性水肿 2 例(5.6%)。结论:沙库巴曲缬沙坦可有效延缓 CAPD 患者残余肾功能的丢失,改善心功能,降低血磷水平。


关键词: 沙库巴曲缬沙坦, 持续性非卧床腹膜透析, 残余肾功能

Abstract: Objective: To investigate the effect of sacubitril⁃valsartan on residual renal function (RRF) in patients with continuous ambulatory peritoneal dialysis (CAPD). Methodology: A retrospective analysis was conducted on 72 CAPD patients followed up in the Department of Nephrology of the First Affiliated Hospital of Anhui University of Chinese Medicine. Patients were divided into an observation group (n=34, taking sacubitril/valsartan) and a control group (n=38). The observation period was 12 months. General data, blood biochemistry, RRF indicators (24⁃hour residual urine volume, residual renal Kt/V, residual renal GFR), peritoneal Kt/V, total Kt/V, left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP), and adverse reactions were recorded. Results: There were no significant differences in baseline indicators between the two groups. During follow⁃up, RRF indicators of both groups decreased; except for residual renal Kt/V, there were significant group×time interaction effects (P interaction <0.05). The observation group had significantly higher residual renal Kt/V than the control group (P=0.041). For cardiac function, there was a significant interaction effect on LVEF (P interaction=0.005), and BNP in the observation group was significantly lower (P<0.001). For blood biochemical indicators, there were significant interaction effects on parathyroid hormone and blood phosphorus (P interaction <0.01), with lower values in the observation group after 12 months. Two cases of dry cough (5.9%) occurred in the observation group, and two cases of angioedema (5.6%) in the control group. Conclusion: Sacubitril⁃valsartan can effectively delay the loss of RRF, improve cardiac function, and reduce serum phosphorus levels in CAPD patients.


Key words: Sacubitril/valsartan, continuous ambulatory peritoneal dialysis, residual renal function