腹膜透析治疗十年以上患者的临床特点

Clinical Characteristics of Patients with Peritoneal Dialysis for More Than Ten Years

目的探讨10年以上腹膜透析患者的临床特征。方法针对245例腹膜透析患者的单中心研究,比较了10年以上组患者(n=20)与小于10年组患者(n=225)的临床特征。检测腹膜转运功能、血压、溶质清除、营养状况以及血液钙、磷酸盐和甲状旁腺激素水平。结果10年以上患者与其他腹透患者的不同之处在于:(1)女性比例较高;(2)体重指数(BMI)较低;(3)原发疾病无糖尿病;(4)腹膜炎发生率较低;(5)残余肾功能较好;(6)甲状旁腺激素水平较低。在10年以上组的患者中,血清白蛋白在10年的随访中保持在一个高水平;腹透治疗后5年和10年的血红蛋白水平均高于治疗开始时;血钙和磷酸盐浓度维持在可接受水平;而透析液/血浆肌酐比值,在长达10年的腹透治疗期间增加。结论接受10年以上腹透治疗的患者腹膜炎发生率较低,BMI较低,血液钙、磷酸盐水平和溶质清除得到充分控制,而且女性患者更多。

Objective:To study the clinical characteristics of patients with peritoneal dialysis for more than 10years.Methods:In a single-center study of 245 patients with peritoneal dialysis,clinical characteristics were compared between patients treated with 10 years or more(n=20)and patients treated with less than 10 years(n=225).Peritoneal transport function,blood pressure,solute clearance,nutritional status,and blood calcium,phosphate,and parathyroid hormone levels were measured.Results:The differences between patients treated over 10 years and other patients with peritoneal dialysis were as follows:(1)the proportion of female was higher;(2)lower body mass index(BMI);(3)the primary disease without diabetes;(4)the incidence of peritonitis was low;(5)good residual renal function;(6)parathyroid hormone level was low.Among patients treated for over 10 years,serum albumin remained at a high level during the 10-year follow-up;hemoglobin levels were higher at 5 and 10 years after peritoneal dialysis than at the beginning of treatment.Maintain acceptable levels of blood calcium and phosphate.The dialysate/plasma creatinine ratio increased during 10 years of peritoneal dialysis.Conclusion:Patients who underwent peritoneal dialysis for more than 10 years had a lower incidence of peritonitis,a lower BMI,adequate control of blood calcium and phosphate levels and solute clearance,among which there were more female patients.