递增式腹膜透析对初期腹膜透析患者血压的影响及机制初探

Effect and Mechanism Exploration of Incremental Peritoneal Dialysis on Blood Pressure in Patients with Peritoneal Dialysis

目的观察3个月内递增式腹膜透析对患者血压的影响及可能机制。方法 50例腹膜透析患者随机分为递增剂量组和常规剂量组,监测患者进入透析时及透析3个月时的动态血压、24h超滤量及尿量、血清白蛋白、透析剂量、J点血压发生频次,计算患者的周尿素清除指数(Kt/V)、肌酐清除率(Ccr)、残余肾功能,比较3个月时的血压高低及J点血压发生频率,分析其影响因素。结果透析3个月时常规剂量组收缩压及舒张压低于递增剂量组;J点血压发生频次高于递增剂量组。超滤量及血浆白蛋白水平可能影响血压的高低。结论递增式腹膜透析在不影响透析充分性的情况下,可获得更低的J点血压发生频率和更平稳的血压。

Objective To investigate the effect and mechanism exploration of incremental peritoneal dialysis on blood pressure in patients with peritoneal dialysis.Methods 50 new peritoneal dialysis patients treated with incremental peritoneal dialysis and continous ambulatory peritoneal dialysis（CAPD） randomly.Ambulatory blood pressure monitoring、ultrafiltration volume、urine volume、albumin、dialysis dose were 、J point blood pressure times were measured on the beginning and three months of peritoneal dialysis.Analyze the possible influencing factors of blood pressure.Results Three months after peritoneal dialysis,systolic blood pressure and diastolic blood pressure was lower in incremental peritoneal dialysis group than in CAPD group.Ultrafiltration volume and the albumi conatration maybe were the influencing factors.Conclusion Patients with incremental peritoneal dialysis at the first three months when start peritoneal dialysis can acquire less J point blood pressure and more stable blood pressure.