中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (03): 145-148.doi: 10.3969/j.issn.1671-4091.2019.03.001

• 专题与讲座 •    下一篇

保护腹膜功能新认识

金蔚1,倪兆慧1   

  1. 1. 上海交通大学医学院附属仁济医院肾脏科
  • 收稿日期:2018-11-15 修回日期:2018-12-10 出版日期:2019-03-12 发布日期:2019-03-05
  • 通讯作者: 倪兆慧 profnizh@126.com E-mail:profnizh@126.com
  • 基金资助:

    上海市中西医临床协作试点建设项目ZY(2018-2020)-FWTX-1001；上海市卫生和计划生育委员会科研课题(201740037)；上海交通大学医学院附属仁济医院临床科研创新培育基金(PYIII-17-009)

Novel understanding of the strategies to preserve peritoneal membrane function in patients on peritoneal dialysis

  • Received:2018-11-15 Revised:2018-12-10 Online:2019-03-12 Published:2019-03-05

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摘要： 【摘要】腹膜透析(peritoneal dialysis, PD)是一种广泛应用的肾脏替代疗法。随着腹膜透析龄的不断延长，患者腹膜功能随之出现改变，特征为对溶质转运加快，对水分超滤逐渐减少，直至发生超滤衰竭(ultra-filtration failure,UFF)，最终导致腹膜透析失败。反复发作的腹膜炎、长期暴露于生物不相容透析液、较长的透析龄是腹膜功能减退的主要影响因素。腹膜相应的解剖学变化包括腹膜纤维化、血管透明变性和血管形成。为了更有效的评估和预测腹膜功能变化，越来越多的生物标记物用于临床实践。对于保护腹膜功能实施切实有效的措施可以延长PD 的时间，提高患者的生存率。近年来，针对保护腹膜功能的措施成为了新的研究热点。本文就近年来国内、国际上有关保护腹膜功能相关措施的最新研究进展进行简述。

关键词: 腹膜透析, 生物标记物, 腹膜功能保护, 预防措施, 治疗干预

Abstract: 【Abstract】Peritoneal dialysis (PD) is a widely used renal replacement therapy. As the increase of PD age in the patients, changes of peritoneal function occur, which is characterized by the increase of solute transport and decrease of ultrafiltration. Ultrafiltration failure (UFF) will eventually lead to PD failure. Recurrent peritonitis, prolonged exposure to bioincompatible dialysate and long dialysis age are the major contributors to peritoneal dysfunction. Corresponding anatomical changes in the peritoneum include peritoneal fibrosis, hyalinizing vasculopathy and angiogenesis. Many biomarkers are clinically used to effectively assess and predict changes of peritoneal function. Implementing effective measures to protect peritoneal function can prolong PD age and improve survival rate of PD patients. Recently, strategies to preserve peritoneal membrane function in PD patients have become a new research hotspot. This review briefly describes the latest research progress in strategies to preserve peritoneal membrane function.

Key words: Peritoneal dialysis, biomarkers, preservation of peritoneal membrane function, preventive measure, therapeutic intervention