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常规的腹膜透析液以葡萄糖作为渗透溶剂,乳酸作为缓冲剂。葡萄糖和乳酸可能会对患者腹膜的结构和功能及全身产生不利影响,导致治疗失败,增加代谢紊乱及心血管疾病的发生率和病死率。因此,近年来研制并发展了一系列生物相容性更好的腹膜透析液,包括使用更符合生理性的碳酸缓冲剂、pH值中性或接近中性的低葡萄糖降解产物(GDP)腹膜透析液,以及使用7.5%葡聚糖或1.1%氨基酸作为渗透溶剂的腹膜透析液。目前关于这些新型腹膜透析液对临床的影响研究结果不完全一致,还缺乏大规模前瞻性的随机对照研究来阐明其对腹膜透析患者生存率及技术生存率的影响。

Clinical studies on peritoneal dialysis solutions.

??Abstract??Use of glucose as the osmotic agent and lactate as buffer in conventional PD solutions may have potentially negative effects on both the structural and functional deterioration of peritoneum and systemic metabolic disturbance??leading to treatment failure and an increase in cardiovascular morbidity and mortality.As a result??more biocompatible solutions containing either less glucose or less lactate are developed.Theoretically these new solutions (NpHLGDP??7.5% icodextrin??1.1% amino acid) may be associated with favorable clinical outcomes.However??the impact of these novel solutions remains largely unknown.Large prospective randomized studies addressing clinical endpoints such as patient and technique survival are presently lacking.