Automated peritoneal dialysis could rapidly improve left heart failure by increasing peritoneal dialysis ultrafiltration: a single-center observational clinical study
Automated peritoneal dialysis could rapidly improve left heart failure by increasing peritoneal dialysis ultrafiltration: a single-center observational clinical study
复制标题
自动化腹膜透析可通过增加腹膜透析超滤快速改善左心衰竭：一项单中心观察性临床研究
DOI：
10.5414/cn109303
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发表时间：
2018-06-01
影响因子：
1.1
通讯作者：
Ai, Jun
中科院分区：
文献类型：
--
作者：
Yang, Cong;Liu, Jixing;Ai, Jun
超滤失败（UFF）是导致水潴留、左心衰（LHF）和腹膜透析（PD）失败的主要原因。自动腹膜透析（APD）可能比持续非卧床腹膜透析（CAPD）具有更好的超滤（UF）。这里.我们研究了短期APD是否可以增加UF和改善LHF。本研究从2015年12月1日至2017年1月1日纳入了47例患者。所有患者在来我中心之前均接受过CAPD治疗，并在医院接受过APD治疗。24-比较两组患者接受短时间APD前后24 h腹腔超滤量、24 h尿量、体重、血压、LHF分级、血肌酐、血尿素氮、白蛋白、钾、血红蛋白、血糖等指标。本研究共入组47例患者（31例男性，平均年龄46.8 ± 16.2岁，平均持续时间26个月（2 - 195个月））。在47例患者中，与CAPD相比，接受短期APD时腹膜透析UF显著增加（1，261.9 +/- 329.6 mL vs. 706.2 +/- 222.3 mL，p < 0.001），APD治疗后3天体重显著降低（57.73 +/- 10.5对比59.81 +/- 10.8，p < 0.001）。接受APD后3天，LHF分级显著降低（1.7 +/- 0.8 vs. 2.4 +/- 1.0，p < 0.001）。APD治疗后3天血压控制良好（SBP为146.6 +/- 14.4 vs. 162.5 +/- 23.8，p= 0.007，DBP为85.6 +/- 11.1 vs. 95.6 +/- 14.7，p = 0.001）。短期APD可显著增加超滤，迅速减轻水肿，改善LHF，可能是治疗PD患者UFF和LHF的有效方法。
Ultrafiltration failure (UFF) is a major cause of water retention, left heart failure (LHF), and peritoneal dialysis (PD) failure. Automated peritoneal dialysis (APD) might have better ultrafiltration (UF) than continuous ambulatory peritoneal dialysis (CAPD). Here. we have studied whether short-term APD could increase UF and improve LHF. 47 patients were included in this study from December 1, 2015, to January 1, 2017. All patients had been treated with CAPD before they came to our center and were treated with APD in the hospital. 24-hour peritoneal UF volume, 24-hour urine volume, body weight, blood pressure, LHF class, serum creatinine, blood urea nitrogen, albumin, potassiwn, hemoglobin, and glucose were collected and compared before and after receiving short-time APD. A total of 47 patients (31 men, mean age 46.8 +/- 16.2 years, mean duration 26 months (2 - 195 months)) were enrolled in this study. Of the 47 patients, peritoneal dialysis UF was significantly increased when receiving short-term APD compared to CAPD (1,261.9 +/- 329.6 mL vs. 706.2 +/- 222.3 mL, p < 0.001), and body weights had significantly decreased 3 days after treatment with APD (57.73 +/- 10.5 vs. 59.81 +/- 10.8, p < 0.001). LHF class was significantly decreased 3 days after receiving APD (1.7 +/- 0.8 vs. 2.4 +/- 1.0, p < 0.001). Blood pressure was well controlled 3 days after treatment with APD (146.6 +/- 14.4 vs. 162.5 +/- 23.8 of SBP, p= 0.007, and 85.6 +/- 11.1 vs. 95.6 +/- 14.7 of DBP, p = 0.001). In conclusion, short-term APD could significantly increase ultrafiltration, rapidly alleviate edema and improve LHF, and might be an effective method to treat UFF and LHF in PD patients.