Peritoneal Transport, Residual Kidney Function and Chronic Inflammation in Peritoneal Dialysis Patients

腹膜透析病患之腹膜運送率、殘餘腎功能與慢性炎症

李隆志(Lung-Chih Lee) ； 李建德(Chien-Te Lee) ； 廖上智(Shang-Chih Liao) ； 許國泰(Kao-Tai Hsu) ； 林景坤(King-Kwan Lam) ； 陳靖博(Jin-Bor Chen) ； 莊峰榮(Feng-Rong Chuang) ； 簡玉樹(Yu-Shu Chien) ； 李志雄(Chih-Hsiung Lee) ； 鄭本忠(Ben-Chung Cheng) ； 吳建興(Ch)

《Acta Nephrologica》 22卷2期 (2008/06) Pp. 105-110

摘要

背景：腹膜運送率及殘餘腎功能和服膜透析病患的預後息息相關。本研究的目的在於探討腹膜透析病患中慢性炎症的盛行率並探討腹膜運送率、殘餘腎功能、慢性炎症及其他臨床因子於腹膜透析病患中的關係。
方法：我們研究100位臨床穩定的腹膜透析病患並紀錄比較其臨床數值、腹膜運送率、殘餘腎功能及高敏感度C-反應蛋白；並使用相關統計及複回歸分析比較各變異因子問的關連性。
結果：有較高腹膜運送率的病患有較長的腹膜透析時間、較高的總肌酸酐廓清率及較低的血清白蛋白值。缺乏殘餘腎功能的病患有較長的腹膜透析時間、較低的總肌酸酐清除率及較高的高敏感度C-反應蛋白。發炎指數高的病患則有較低的餘尿量及腎廓清率。腹膜運送率和血清白蛋白及餘尿量呈負相關。身體質量指數及血清總膽固醇為C-反應蛋白之獨立相關因子。
結論：腹膜之通透性隨著腹膜透析的時問延長而增加並伴隨較低的血清白蛋白；殘餘腎功能的減少則伴隨高敏感度C-反應蛋白上升；而身體質量指數及血脂異常與腹膜透析病患的慢性炎症有明顯相關。

關鍵字

腹膜運送率 ； 殘餘腎功能 ； 慢性炎症 ； 腹膜透析

並列摘要

Background: Both peritoneal transport characteristics and residual kidney function (RKF) are closely related to the outcome of peritoneal dialysis (PD) patients. In the present study, we examine the prevalence of chronic inflammation and study the relationship between peritoneal clearance character, RKF chronic inflammation and clinical features of PD patients.
Methods: We studied 100 clinically stable PD patients and their demographic data, peritoneal transport rate (PTR) and RKF were reviewed and recorded. Biochemical data and serum high sensitivity C-reactive protein (hsCRP) were measured. Correlation studies and multiple regression analysis were performed among variables.
Results: Patients with high PTR had longer PD duration, higher total creatinine clearance and lower serum albumin. Lack of RKF was associated with longer PD duration, lower total creatinine clearance and higher hsCRP. Mare inflamed patients had a lower amount of urine and lower renal clearance. The PTR correlated negatively with serum albumin and urine amount. Body mass index and cholesterol level were independent markers of the hsCRP level.
Conclusions: Peritoneal permeability increased with PD duration and was associated with a lower albumin level. A decrease in RKF was related to demotion of hsCRP level. Both body mass index and dyslipidemia were independently relevant with chronic inflammation in PD patients.

並列關鍵字

peritoneal transport ； residual kidney function ； chronic inflammation ； peritoneal dialysis