The Morbidity and Mortality of the Dialysis Patient with Liver Cirrhosis in Comparison Hemodialysis to Continuous Ambulatory Peritoneal Dialysis

合併肝硬化之透析病人接受血液透析與腹膜透析的罹病率與死亡率之比較

林博文(P. W. Lin) ； 高銘聰(M. T. Kao) ； 鄭裕文(Y. W. Cheng) ； 鍾錫裕(S. Y. Chung) ； 周銘源(M. Y. Chou) ； 賴銘南(M. N. Lai) ； 郭元銓(Y. C. Kuo) ； 許逸生(I. S. Hsu)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 322-322

並列摘要

Purpose: The patients who suffer and stage renal disease and liver cirrhosis have malnutrition, immunocompromise and low systemic vascular resistance. To maintain dry weight via ultrafiltration is always difficult in hemodialysis (HD) because of intradialytic hypotension. Continuous ambulatory peritoneal dialysis (CAPD) is an alternative therapy for these patients. However, albumin loss in dialysate and increase in infections rate are the major problems. This study compared HD with CAPD in the morbidity and mortality of these patients.
Methods: We analyzed dialysis patients with liver cirrhosis who were admitted from 1996 to 2000 at our hospital. There were 19 HD patients with 38 times of hospitalization and 14 CAPD patients with 19 times of hospitaliaton.
Result: Mortality rate was 5/19(26.3%)in HD and 6/14 (42.9%) in CAPD. The cause of death were septic shock (n=3), esophageal varices bleeding (n=2) in HD patients; septic shock (n=5), hepatoma (n=1) in CAPD patients, respectively. The patients in HD had longer days of hospitalization, higher rate of hepatic encephalopathy, lower platelet count, more prolong activated partial thromboplastin time, higher level alanine aminotransferase and total bilirubin than those in CAPD (p＜0.05).
Conclusion: We conluded that there was no difference in albumin level between both groups but liver dysfunction was more apparent in HD. The mortality rate was lower in HD, but the morbidity rate was lower in CAPD. Causes of death in both HD and CAPD were mainly septic shock, hepatic related diseases, instead of uremia.