糖尿病肾病腹膜透析38例临床分析

Comparison of mortality rates between peritoneal dialysis and hemodialysis in diabetic nephropathy patients

目的 观察腹膜透析 (PD)及血液透析 (HD)在糖尿病肾病肾脏替代治疗中的利弊。方法 选取我院糖尿病肾病患者 ,其中行血液透析 2 4例 ,腹膜透析 38例 ;两组患者的性别、透析前的年龄及残余肾功能均相匹配 ;比较两组的生存率及血脂、血糖、白蛋白、血红蛋白等指标。结果 两组前 2年的生存率差异无显著性 ;腹膜透析组第 3年的生存率大幅下降 ,明显低于血液透析组 (P <0 0 1) ;PD组的空腹血糖、甘油三酯及低密度脂蛋白均高于HD组 ,差异有显著性。PD组的血浆白蛋白水平显著低于HD组 (P <0 0 5 ) ,而血红蛋白则高于HD组。结论 对于糖尿病肾病的肾脏替代治疗 ,腹膜透析相对于血液透析仍存在一些不完善的地方 ;是否以腹膜透析作为糖尿病肾病终末期的首选治疗方案 ,尚需大量的。

Objective To evaluate and compare the different survival rates and clinical outcome of continuous ambulatory peritoneal dialysis (PD) and hemodialysis (HD) treatment in diabetic patients Methods 62 diabetic patients suffering from end stage renal complication were treated with PD or HD The age, sex and residual renal function of the two groups were matching Their survival rates and levels of blood lipid, blood sugar, serum albumin and hemoglobin were observed Results The mortality rates of HD and PD were not significantly different in the first two years But mortality of PD increased rapidly after two years of treatment The levels of blood triglycerides, low density lipoprotein cholesterol and fasting sugar in PD patients were higher than that in HD patients, while the concentration of serum albumin was lower than HD patients significantly Conclusions In diabetic patients with renal failure PD as a choice to replace the kidney function was not superior to HD, especially after two years of PD treatment A close watch is necessary to detect the change of parameter levels mentioned above and if is better to shift to HD A strict long term and extensive survey is needed to compare these two methods further