APD在CKD5期心肾综合征患者中的疗效观察

目的探讨自动化腹膜透析（automated peritoneal dialysis, APD）对于慢性肾脏疾病（chronic kidney disease，CKO）5期心肾综合征的治疗效果。方法回顾性分析我院（同济医院）30例慢性肾脏疾病5期心肾综合征予以腹透置管术后并立即进行自动化腹膜透析治疗的患者，观察应用自动化腹膜透析治疗前后心功能不全症状、血肾功能、血红蛋白、血B型脑钠肽（brain natriuretic peptide, BNP）、平均收缩压、血钾等指标变化。结果30例患者经自动化腹膜透析治疗，平均疗程为109．2±36．4h，腹透液总量为8．67±4．34L，平均每日腹透液超滤量为640．0±480．0ml。其中29例心功能不全症状均好转，治疗后患者氮质血症症状、血BNP、收缩压等均较治疗前下降（P〈0．05）。结论CKD5期心肾综合征患者腹透置管术后两周以内应用APD治疗CKD5期心力衰竭．能早期改善患者毒素潴留和心功能不全症状。

Application of automated peritoneal dialysis for cardiorenal syndrome in patients with chronic kidney disease stage 5

Objective To assess the efficacy of automated peritoneal dialysis （APD） for cardiorenal syndrome in patients with chronic kidney disease （CKD） stage 5. Methods Thirty hospitalized CKD stage 5 patients with cardiorenal syndrome were enrolled in the study. APD was performed immediately after catherization for peritoneal dialysis. The changes of symptoms of cardiac insufficiency, renal function, hemoglobin, plasma brain natriuretic peptide （BNP） and serum potassium were observed before and after APD treatment. Results The average course of treatment was 109.2 ±36.4 h with the total dialysate of 8. 67 ±4.34 L. After treatment, the symptoms of cardiac insufficiency and azotemia were improved in 29 cases. Plasma BNP and systolic blood pressure were decreased （P 〈 0.05） after APD treatment. Conelusion Early APD treatment can improve the symptoms of uremic toxin retention and cardiac insufficiency.