腹膜透析剂量与残余肾功能及透析质量的关系研究

目的观察慢性肾脏病5期患者应用非透析治疗、不同腹膜透析剂量治疗对肾功能的影响。方法选取慢性肾脏病5期的非糖尿病肾病患者，采用非透析保守治疗者20例，腹膜透析剂量4升／天者26例、6升／天者35例及8升／天者43例。随访观察1年，检查各项指标及肾功能的变化。结果随访1年后，非透析患者血压的控制较4升／天腹膜透析组差（P〈0．05），血清白蛋白水平、血钙水平低于4升／天透析组，血磷及甲状旁腺素水平高于不同剂量透析组。各组尿量及残余肾功能均有不同程度的下降，其中腹膜透析各组尿量、肾功能及非透析组肾功能均较观察前具有统计学差异（P〈0．05），而各组之间肾功能下降的幅度未见显著性差异（P〉0．05）。结论慢性肾脏病5期患者早期的腹膜透析治疗对患者钙磷代谢、蛋白质营养改善及血压的控制优于非透析治疗。腹膜透析治疗对残余肾功能的保护与非透析治疗相比未见明显优势，不同的透析剂量在1年的观察期内未显示对肾功能的影响。

Effect of peritoneal dialysis dose on residual renal function and quality of dialysis

Objective To investigate the effect of different dose of peritoneal dialysis （PD） on renal function in ESRD patients. Methods Non-diabetic CKD5 patients received PD therapy with dif- ferent doses（4 L/day for 26 cases,6 L/day for 35 cases and 8 L/day for 43 cases）, and 20 cases re ceived no-PD conservative treatment（control）. Renal function and quality of dialysis were evaluated af- ter a follow-up period of l 2 months. Results The levels of serum albumin and calcium in control group were lower than in 4 L/day PD group （P~ I）. 05 ）, and those of serum phosphorus and PTH were higher than in all PD groups（P%0.05 ）. Renal function and urine volume in all groups were decreased after 12 months（P~ 0.05）. No significant difference in the decreased range of renal function was found among all groups. Conclusions Early dialysis for CKD5 patients is benefit for nutrition state, electrloyte balance and blood pressure control. Different doses of dialysis show no influence on renal function.