[1]白梦婷,李思宇,程 力.腹膜透析患者治疗后腹膜溶质转运速率升高危险因素分析[J].陕西医学杂志,2024,(7):944-948.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.017]
　BAI Mengting,LI Siyu,CHENG Li.Risk factors for increased peritoneal solute transport rate in peritoneal dialysis patients after treatment[J].,2024,(7):944-948.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.017]
点击复制

腹膜透析患者治疗后腹膜溶质转运速率升高危险因素分析
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年7期
页码:
944-948
栏目:
临床研究
出版日期:
2024-07-05

文章信息/Info

Title:
Risk factors for increased peritoneal solute transport rate in peritoneal dialysis patients after treatment
作者:
白梦婷1; 2; 李思宇1; 2; 程 力1; 2
(1.武汉市第一医院肾内科,湖北 武汉 430022; 2.华中科技大学同济医学院第四教学医院肾内科,湖北 武汉 430000)
Author(s):
BAI Mengting; LI Siyu; CHENG Li
(Department of Nephrology,Wuhan No.1 Hospital,Wuhan 430022,China)
关键词:
终末期肾病;  腹膜透析;  腹膜转运特征;  4 h腹膜透析液与2 h血肌酐比值;  腹膜溶质转运速率;  透析时间;  血清白蛋白水平
Keywords:
End-stage renal disease;  Peritoneal dialysis;  Peritoneal transport characteristics;  D/Pcr;  Peritoneal solute transport rate;  Dialysis age;  Serum albumin level
分类号:
R 692
DOI:
DOI:10.3969/j.issn.1000-7377.2024.07.017
文献标志码:
A
摘要:
目的:探究影响腹膜透析治疗后腹膜溶质转运速率(PSTR)升高的危险因素。方法:回顾性纳入接受腹膜透析治疗的终末期肾病患者209例,随访观察腹膜透析治疗1年后腹膜转运特征分布; 复查腹膜平衡实验,观察4 h腹膜透析液与2 h血肌酐比值(D/Pcr)相比基线的变化情况,分为PSTR升高组和降低组。基于人口学特征和实验室指标,通过Logistic回归分析影响PSTR升高的危险因素。结果:入组209例腹膜透析患者,基线腹膜转运特征以低平均转运和高平均转运为主,基线D/Pcr为0.64±0.15。腹膜透析治疗1年时,约64.1%患者PSTR升高,D/Pcr值为0.73±0.12,明显高于基线D/Pcr值,差异有统计学意义(t=-6.773,P<0.05)。PSTR升高组D/Pcr、糖尿病肾病比例及透析时间大于PSTR降低组,基线D/Pcr值及基线血清白蛋白和血镁水平低于PSTR降低组,差异具有统计学意义(均P<0.05)。Logistic回归分析,基线D/Pcr值、糖尿病肾病、透析时间越长及基线血清白蛋白水平是影响PSTR升高的独立危险因素(均P<0.05)。结论:随着腹膜透析治疗时间延长,D/Pcr值逐渐升高,患者腹膜溶质转运速率呈增高趋势; 基线低D/Pcr、透析时间越长、糖尿病肾病及基线血清白蛋白水平降低是影响腹膜透析治疗后腹膜溶质转运速率升高的独立危险因素。
Abstract:
Objective:To explore the Risk factors for increased peritoneal solute transport rate(PSTR)in peritoneal dialysis patients after treatment.Methods:A total of 209 patients with end-stage renal disease treated with peritoneal dialysis were retrospectively enrolled.The characteristics and distribution of peritoneal transport were observed after 1 year of peritoneal dialysis treatment.Peritoneal balance test was reviewed to observe the change of the ratio of peritoneal dialysate to 2-hour serum creatinine(D/Pcr)compared with the baseline D/Pcr value,which was divided into increased and decreased PSTR groups.Based on demographic characteristics and laboratory indicators,Logistic regression analysis was performed to explore the risk factors affecting the increase of PSTR.Results:Of 209 peritoneal dialysis patients,baseline peritoneal transport characteristics were mainly low mean transport and high mean transport,and baseline D/Pcr was 0.64±0.15.At 1 year of peritoneal dialysis treatment,64.1% of patients with increased PSTR,D/Pcr value of 0.73±0.12,significantly higher than baseline D/Pcr value(t=-6.773,P<0.05).The D/Pcr,diabetic nephropathy and dialysis age of increased PSTR group were higher than those of decreased PSTR group,and the baseline D/Pcr value,serum albumin and blood magnesium levels were lower than those of decreased PSTR group,the differences were statistically significant(all P<0.05).Logistic regression analysis showed that baseline D/Pcr value,diabetic nephropathy,dialysis age and baseline serum albumin level were independent risk factors for increased PSTR(all P<0.05).Conclusion:With the extension of peritoneal dialysis treatment time,D/Pcr value gradually increased,and the transport rate of peritoneal solute shows an increasing trend.Low D/Pcr at baseline,long dialysis age,diabetic nephropathy and lower serum albumin level at baseline were independent risk factors for increasing peritoneal solute transport rate after peritoneal dialysis treatment.

参考文献/References:

[1] BRAUN M M,KHAYAT M.Kidney disease:End-stage renal disease[J].FP Essent,2021,509:26-32.
[2] 张志勇,李明旭,于海,等.自动化腹膜透析对终末期肾衰竭患者心功能和临床症状的影响[J].陕西医学杂志,2020,49(29):1130-1133.
[3] WANG Y,LI Y,WANG H,et al.Early-start and conventional-start peritoneal dialysis:A Chinese cohort study on outcome[J].Ren Fail,2020,42(1):305-313.
[4] 赵楠,董捷.腹膜透析患者腹膜功能评估方法的进展[J].中国血液净化,2019,18(9):591-594.
[5] 刘莹,张庆燕,蒋春明,等.基于腹膜转运功能探讨的腹膜透析患者远期预后[J].中国血液净化,2022,21(5):331-335.
[6] WILLIAMS J,GILCHRIST M,STRAIN W D,et al.An exploratory study of the relationship between systemic microcirculatory function and small solute transport in incident peritoneal dialysis patients[J].Perit Dial Int,2022,42(5):513-521.
[7] CHOU Y H,CHEN Y T,CHEN J Y,et al.Baseline peritoneal membrane transport characteristics are associated with peritonitis risk in incident peritoneal dialysis patients[J].Membranes(Basel),2022,12(3):276.
[8] BRIMBLE K S,WALKER M,MARGETTS P J,et al.Meta-analysis:Peritoneal membrane transport,mortality,and technique failure in peritoneal dialysis[J].J Am Soc Nephrol,2006,17(9):2591-2598.
[9] 陈香美,倪兆慧,付平,等.腹膜透析标准操作规程[M].北京:人民军医出版社,2012:96-98.
[10] TWARDOWSKI Z,NOLPH K,KHANNA R.Peritoneal equilibration test[J].Perit Dial Bull,1987,7(3):138-147.
[11] EVANS M,LEWIS R D,MORGAN A R,et al.A narrative review of chronic kidney disease in clinical practice:Current challenges and future perspectives[J].Adv Ther,2022,39(1):33-43.
[12] 张晓丽.血液透析联合血液灌注对糖尿病肾病患者血清空腹血糖、 C反应蛋白、白细胞介素-6影响的临床研究[J].陕西医学杂志,2020,49(1):68-71.
[13] 顾怡钰,杨昕宇,徐明珠,等.腹膜透析充分性对心脏结构和功能的影响[J].肾脏病与透析肾移植杂志,2021,30(1):25-30.
[14] LI S Y,CHUANG C L,LIN C C,et al.Peritoneal-membrane characteristics and hypervolemia management in peritoneal dialysis:A randomized control trial[J].Membranes(Basel),2021,11(10):768.
[15] ASANO M,ISHII T,HIRAYAMA A,et al.Differences in peritoneal solute transport rates in peritoneal dialysis[J].Clin Exp Nephrol,2019,23(1):122-134.
[16] 李路洁,马东红.腹膜透析患者基线腹膜转运特征及高转运的影响因素[J].河南医学研究,2021,30(25):4641-4644.
[17] WANG H,TIAN J,DU F,et al.Effect of peritoneal transport characteristics on clinical outcome in nondiabetic and diabetic nephropathy patients with peritoneal dialysis[J].Iran J Kidney Dis,2019,13(1):56-66.
[18] 武蓓,赵慧萍,芦丽霞,等.影响腹膜透析患者腹膜溶质转运速率增快的因素分析[J].中国血液净化,2023,22(2):119-122.
[19] GUEDES A M.Peritoneal protein loss,leakage or clearance in peritoneal dialysis,where do we stand?[J].Perit Dial Int,2019,39(3):201-209.
[20] 唐静,付平,钟慧.初次腹膜透析患者腹膜高转运特性的危险因素[J].华西医学,2021,36(11):1556-1562.
[21] MALHO GUEDES A,CALCAS MARQUES R,DOMINGOS A T,et al.Protein loss in peritoneal effluent:Different meaning for 24 h versus PET samples[J].Blood Purif,2023,52(2):193-200.
[22] MARGETTS P J,MCMULIIN J P,RABBAT C G,et al.Peritoneal membrane transport and hypoalbuminemia:Cause or effect?[J].Perit Dial Int,2000,20(1):14-18.
[23] LO W K,BRENDOLAN A,PROWANT B F,et al.Changes in the peritoneal equilibration test in selected chronic peritoneal dialysis patients[J].J Am Soc Nephrol,1994,4(7):1466-1474.
[24] MATSUDA A,MATSUMURA O,OGAWA T,et al.Contribution of residual renal function on peritoneal solute transport in dialysis patients[J].Am J Nephrol,2010,32(3):187-193.

相似文献/References:

[1]吴玲那,韩继明,王 瑾.延安市血液透析患者自我管理现状调查研究*[J].陕西医学杂志,2019,(6):810.
[2]王 颖,白若钥△.凝血-纤溶失衡评价在预测维持性血液透析患者血管通路栓塞中的应用价值[J].陕西医学杂志,2020,49(11):1448.[doi:DOI:10.3969/j.issn.1000-7377.2020.11.020]
　WANG Ying,BAI Ruoyue..Application value of coagulation-fibrinolysis imbalance in predicting vascular access failure in maintenance hemodialysis patients[J].,2020,49(7):1448.[doi:DOI:10.3969/j.issn.1000-7377.2020.11.020]

备注/Memo

备注/Memo:
基金项目:湖北省卫生健康委员会青年人才项目(MY2021Q001)
更新日期/Last Update: 2024-07-04