关键词: 中国人, 腹膜透析, 理想透析剂量

Abstract:

NKF-DOQI proposed a target Kt/V of 2.0 per week for continuous ambulatory peritoneal dialysis (CAPD). But in Hong Kong，using three 21 dwells daily，a number of investigators have reported patient and technique survival rates superior to those in most western countries. Objective To investigate the ideal peritoneal dialysis dose suitable for Chinese people. Method On the basis of nitrogen kinetic modeling, we compare the adequacy indexes in CAPD patients dialyzed with 6L/d or 8L/d. Results TBZW71 patients (26 in 6L/d, 45 in 8L/d) participated in the study. In 6L group, DPI and nPCR was (0.91±0.36)g/kg/d and (0.89±0.24)g/kg/d respectively, actual Kt/V and theoretic Kt/V is comparable. In 8L group, nPCR (0.86±0.15) g/kg/d significantly higher than DPI (0.79±0.22) g/kg/d and actual Kt/V higher than theoretic Kt/V. Fluid clearance had no difference between the two groups(1098±523)ml/d vs. (1131±451)ml/d. But there was more urine volume［(635±591)ml/d vs (269±352)ml/d］ and less ultrafiltration ［(463±512)ml/d vs. (862±415)ml/d］ in 6L group. There was no difference in the management of hypertension, anemia, hyperphosphatemia, acidosis, quality of life and malnutrition between the two groups. Conclusion Dialysis dose should be individualized according to dietary intake and residual renal function. Three 2L dwells daily is sufficient for small-solute clearance in our patients with their present DPI level. With the vanishing of residual renal function, attention should be paid to prescribe high-tonic dialysate or more dialysis dose to acquire fluid balance.

Key words: Peritoneal dialysis, Ideal dialysis dose 