腹膜透析清除钠的相关因素分析及其临床意义

Factors relating to sodium clearance in peritoneal dialysis and their clinical significance

目的揭示腹膜透析患者钠清除的相关因素。方法 156例维持性腹膜透析患者,行改良腹膜平衡试验和透析充分性检查,对结果做多元线性回归分析。结果揭示了腹膜对钠清除的影响因素有透析剂量、每日净超滤量、血钠与新鲜透析液钠浓度差值和钠沉降率,总钠清除的影响因素有每日净超滤量、每日尿量、血钠与新鲜透析液钠浓度差值和钠沉降率。多元线性回归分析显示有显著相关性(P<0.01)。结论使用传统的腹膜透析液和足够的液体清除量是保证足够的钠清除量的最重要条件;使用低钠透析液应该是解决钠潴留的有效办法;评价透析充分性应包含钠清除的指标。

Objective To explore the factors relating to sodium clearance in peritoneal dialysis patients.Methods A total of 156 maintenance peritoneal dialysis patients who had completed the modified peritoneal equilibrium test（PET） and dialysis adequacy test were enrolled in this study.Multifactor regression analysis was used for data analysis.Results This study firstly disclosed the influence factors relating to the peritoneal sodium removal,including infusion volume and ultrafiltration every day,sodium dip during modified PET,and sodium concentration difference between serum and fresh dialysate.The influence factors relating to total sodium clearance included ultrafiltration every day,urine volume every day,sodium dip during modified PET,and sodium concentration difference between serum and fresh dialysate.Multifactor regression analysis indicated the presence of significant relationships.Conclusions（1） Sufficient fluid removal is necessary for adequate sodium removal when traditional dialysate is used;（2） Low sodium dialysate may be useful for the relief of sodium retention;（3） Index of sodium clearance should be included in the evaluation of dialysis adequacy.