腹膜透析治疗急性肾损伤的研究进展

Peritoneal dialysis in acute kidney injury

腹膜透析(peritoneal dialysis,PD)是急性肾损伤(acute kidney injury,AKI)进行肾脏替代治疗的适当方法。软性PD导管是PD治疗AKI时建立透析通路的金标准。目前尚无公认的最优PD治疗AKI时的植管方法。对于稳定的AKI患者,PD治疗时每周Kt/V目标值最低标准可设为2.1。对于危重患者,PD治疗时每周Kt/V目标值可设为3.5。在采用高容量腹膜透析(high volume peritoneal dialysis, HVPD)治疗AKI时,自动化腹膜透析(automated peritoneal dialysis, APD)更能节省人力,较手工PD具有明显优势。然而,PD治疗AKI存在一定局限性,仍需高质量临床研究进行进一步证实。

Peritoneal dialysis (PD)is a useful method of renal replacement therapy for acute kidney injury (AKI).Flexible catheter for PD access is the gold standard in this situation.At present,the best catheterization method for PD inAKI patients is unavailable.The lowest weekly Kt/V of PD can be set at 2.1 for relatively stable AKI patients and at 3.5 for critically ill patients.Automated peritoneal dialysis (APD)is more labor-saving than manual PD in the treatment of AKI with high volume peritoneal dialysis (HVPD).However, there remain some limitations for PD in treatment of AKI.High quality clinical studies are required for further confirmation.