腹膜透析治疗充分性评估与影响因素干预

Assessment of peritoneal dialysis adequacy and management of its influencing factors

腹膜透析(PD)充分性是PD患者预后的关键因素,目前国内外常用的小分子溶质清除指标为每周尿素清除指数(Kt/V)。Kt/V已经由既往指南的>2.0,降低到≥1.7即可。除了小分子溶质清除外,容量平衡、营养状态、临床症状等也是透析充分性的评估指标。因此,PD充分性评估既有小分子溶质的清除,也包括其他综合性因素。影响透析充分性的因素中,残余肾功能、腹膜转运特性为主要因素,应予以足够重视并定期监测。

Peritoneal dialysis （PD） adequacy is the key factor of prognosis in PD patients. Interventional studies have demonstrated that total Kt/V urea should not be less than 1.7 at any time. Besides small solutes clearance, there are other assessment parameters of PD adequacy, including volume balance, nutritional status, clinical symptoms, etc. PD adequacy should be assessed comprehensively according to the above parameters. Attention should be focused on residual renal function and peritoneal transport characteristics, which impact PD adequacy greatly.