Hemodialysis together with peritoneal dialysis is one of the simplest ways to maintain adequacy in continuous ambulatory peritoneal dialysis.
Hemodialysis together with peritoneal dialysis is one of the simplest ways to maintain adequacy in continuous ambulatory peritoneal dialysis.
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血液透析与腹膜透析相结合是维持连续门诊腹膜透析充分性的最简单方法之一。
DOI：
10.1177/089686080602600205
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
S. Tsuchiya
中科院分区：
文献类型：
--
作者：
H. Kawanishi;M. Moriishi;S. Katsutani;E. Sakikubo;S. Tsuchiya
当长期进行腹膜透析（PD）而不改变透析处方时，会因透析剂量不足而出现尿毒症症状。在这种情况下，需要增加透析液容量，但由于腹部体积、生活方式或体重的限制，这种增加很难在所有患者中实现。 PD 和血液透析 (HD) 的结合是克服这些限制的最简单方法。我们的患者接受了联合治疗——HD 每周一次，持续 4 小时，PD 每周 6 天。每周总透析剂量（尿素）计算如下：为了将 HD 的透析剂量转换为连续治疗的剂量，计算等效肾尿素清除率（EKR）并将其添加到 PD 的透析剂量中。 12 名患者进行了联合治疗。联合治疗的原因包括2名患者超滤（UF）丢失、3名患者尿毒症症状、5名患者液体管理不良、1名患者脐疝和1名患者胸水。这些患者每周的总 Kt/V 从 1.61 +/- 0.19 增加到 2.05 +/- 0.25。在 2 名 UF 减少的患者中，开始联合治疗后体重控制变得更容易，并且仅使用低渗透析液就可以控制体重。有尿毒症症状的患者，症状有所改善；此外，这些患者的皮肤色素沉着得到改善。综上所述，联合治疗后透析剂量增加，体液可控，尿毒症症状得到改善，生活质量提高。
When long-term peritoneal dialysis (PD) is performed without change in the dialysis prescription, uremic symptoms appear owing to insufficient dialysis dose. In such cases, an increase in dialysate volume is required, but this increase is difficult to obtain in all patients owing to limitations in abdominal volume, lifestyle, or body weight. A combination of PD and hemodialysis (HD) is the simplest method of overcoming these limitations. Combination therapy--HD once per week for 4 hours and PD 6 days per week--was performed in our patients. The total weekly dialysis dose (urea) was calculated as follows: to convert the dialysis dose by HD to that of continuous treatment, the equivalent renal urea clearance (EKR) was calculated and added to the dialysis dose by PD. Combination therapy was performed in 12 patients. The reasons for the combination therapy included ultrafiltration (UF) loss in 2 patients, uremic symptoms in 3 patients, poor fluid management in 5 patients, umbilical hernia in 1 patient, and hydrothorax in 1 patient. Total Kt/V per week was increased from 1.61 +/- 0.19 to 2.05 +/- 0.25 in these patients. In the 2 patients with UF loss, weight control became easier after the combination therapy was started, and this control was possible with hypotonic dialysate alone. In patients with uremic symptoms, the symptoms improved; furthermore, dermal pigmentation improved in these patients. In summary, the dialysis dose was increased and body fluids became controllable after inducing combination therapy, resulting in improvement uremic symptoms and increased quality of life.