腹膜透析治疗老年慢性肾功能衰竭的临床分析

目的 分析持续性腹膜透析(PD)治疗老年慢性肾功能衰竭(CRF)患者的临床效果,探讨PD在老年CRF患者中的应用经验.方法 回顾性分析89例老年CRF患者接受PD(简称老年PD组)治疗后的临床表现和生化指标、主要并发症、存活率、死亡原因等,并与53例非老年PD组相比较.结果 老年PD组的原发疾病以糖尿病(37.08%)、原发性高血压(30.34%)为主,而非老年PD组则以肾小球肾炎(54.72%)为主.两组患者的1年与3年存活率差异无统计学意义,腹膜炎仍是两组患者退出PD的主要原因.老年组的病死率明显高于非老年组,感染与心脑血管病是两组患者的主要并发症和死亡原因.低钾血症在老年PD患者中非常普遍.结论 腹膜透析在老年CRF患者的治疗中有效,但长期存活仍受腹膜炎、心脑血管病并发症的影响,老年PD患者的低钾血症应引起足够的重视.

Clinical analysis of peritoneal dialysis in elderly chronic renal failure patients

Objective To investigate the clinical effects and experiences of peritoneal dialysis(PD)on elderly chronic renal failure(CRF) patients. Methods The clinical data of 89 elderly CRF patients(≥60years) and 53 non-elderly CRF patients (＜60 years)treated with PD were collected and analyzed. The clinical data included clinical menifestations,laboratory results, main complications, survival rate, the cause of death,etc. Results Primary diseases of the elderly CRF patients were mostly diabetes mellitus (37.08%) and hypertension(30.34%) ,while of non-elderly group were chronic glomerulonephritis(54.72%). The 1-year and 3-year survival rates of the two groups had no difference. Peritonitis was still the main cause of withdraw from PD in both groups. The main complications and causes of death were infections, cardiovascular and cerebralvascular disease. Hypokalemia was common in elderly PD patients. Conclusions Peritoneal dialysis is an effective method, especially suitable for elderly patients for continuous treatment. The long-term survival is affected by peritonitis and cardiovascular and cerebralvascular complications. Hypokalemia in elderly PD patients must be considered seriously.