残余肾功能对腹膜透析患者营养状况的影响

目的：探讨残余肾功能（ＲＲＦ）对持续不卧床腹膜透析（ＣＡＰＤ）患者营养状况的影响。方法：研究对象分为３组：对照组、Ａ组（ＲＲＦ〈３ｍｌ／ｍｉｎ）和Ｂ组（ＲＲＦ≥３ｍｌ／ｍｉｎ）。患者均采用常规处方透析，并抽血检测生化、血脂及蛋白营养指标，计算ＲＲＦ、尿素清除指数（ＫＴ／Ｖ）、周肌酐清除率（Ｃｃｒ／ｗ）、单位透析剂量（ＰＶ／Ｓ）及蛋白质分解率（ＰＣＲ），评估每日蛋白质摄入量（ＤＰＩ）。结果：ＲＲＦ与ＫＴ／Ｖ，Ｃｃｒ／ｗ及残余尿量呈正相关（ｒ分别为０．５６，０．８３，０．８０），与透析时间、透析超滤量呈负相关（ｒ分别为－０．４１，－０．３３），与ＰＶ／Ｓ无关。Ａ组患者Ｃｃｒ／ｗ，ＫＴ／Ｖ及血浆前清蛋白（ＰＡ）、视黄醇结合蛋白（ＲＢＰ）、转铁蛋白（Ｔｆ）明显低于Ｂ组，但ＰＣＲ高于Ｂ组。Ａ、Ｂ两组间三酰甘油、清蛋白及胆

Effects of residual renal function on nutritional condition in peritoneal dialysis patients

Objective:To investigate the effects of residual renal function(RRF) on nutritional conditions in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods:Sixty-three patients were divided into 3 groups:control group,group A(RRF<3 ml/min) and group B (RRF≥3ml/min).Patients all underwent regularly prescribed dialysis;blood urea nitrogen,creatinine,lipid and albumin were measured to calculate RRF,KT/V,clearance of creatinine (Ccr/w),PV/S and protein catabolic rate (PCR).Daily protein intakes (DPI) was evaluated.Results:RRF had positive correlation with KT/V,Ccr/w and volume of residual urine (r= 0.56,0.83,0.80,respectively),had negative correlation with dialysis time,volume of ultrafiltration (r=-0.41 and -0.33,respectively),and had no correlation with PV/S.Levels of Cor/w,KT/V,prealbumin(PA),retinol-binding protein (RBP) and transferrin were significantly lower in Group A than Group B,while PCR was higher in Group A than Group B.However,no significant difference was found in Alb,TG and Tch in 2 groups.Conclusion:RRF is closely related with the adequacy of peritoneal dialysis and may affect the nutritional condition of CAPD patients.The main way to prevent malnutrition in CAPD patients is to timely adjust the prescripition of dialysis based on their RRF.