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我国腹膜透析患者充分透析剂量的理论探讨 被引量:2

An adequate dialysis dose in Chinese patients with peritoneal dialysis
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摘要 目的 :探讨腹膜透析 (PD)患者充分透析剂量以及通过降低透析剂量达到降低透析成本的可行性。  方法 :应用尿素动力学原理 ,在氮平衡的基础上对PD患者透析剂量进行推算。  结果 :透析剂量取决于患者蛋白质摄入量及体重 ;残余肾功能对透析剂量有很大影响。当残肾功能为零时 ,相同体重患者随着每天蛋白质摄入量 (DPI)增加 ,其透析剂量也相应的增加 ;当DPI一定时 ,残肾功能低者 ,其采用的透析剂量大。  结论 :我国PD患者维持氮平衡状态时蛋白质的摄入量低于西方人 ,且体重较轻 ,在此基础上所需的理论透析剂量较西方传统的透析剂量低 ,理论上通过降低透析剂量达到降低透析成本的目的是可行的 。 Objective:To study the adequate dialysis dose in Chinese patients with peritoneal dialysis and to discuss the feasibility of decreasing dialysis cost by reducing dialysis dose. Methodology:Based on the nitrogen balance we selected patients with clinical stable peritoneal dialysis, and then applied urea kinetic modeling to calculate their minimal adequate dialysate volume. Results:The major determinants of dialysate volume are the dietary protein intake and body weight. The presence of residual renal function has a profound effect on the prescribed dialysate volume. When the residual renal function was absent, dialysate volume increased with dietary protein intake in the same body weight. If dietary protein intake was stable, dialysate volume increased when residual renal function decreased. Conclusion:Due to the lower dietary protein intake while maintaining adequate nutritional status in patients with peritoneal dialysis, it is therefore theoretically possible to reduce the dialysis cost by decreasing the dialysis dose. To preserve the residual renal function may result in reducing the dialysis dose.
作者 王玲 汪涛
出处 《肾脏病与透析肾移植杂志》 CAS CSCD 2004年第3期240-243,共4页 Chinese Journal of Nephrology,Dialysis & Transplantation
基金 中华人民共和国教育部长江学者奖励计划 教育部教育振兴行动计划专项基金 ( 985工程 )资助
关键词 腹膜透析 透析剂量 PD 氮平衡 尿素动力模型 血液净化 blood purification kinetic modeling dialysate volume nitrogen balance
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