PDF(Pubmed)
Abstract：
Residual kidney function (RKF) has been associated with better survival, less morbidity, and improved quality of life in peritoneal dialysis (PD) patients. Since higher peritoneal clearance does not lead to better outcomes, more emphasis should be put on preserving kidney function. Many other benefits have been reported, including better volume and blood pressure control, better nutritional status, lower rates of PD peritonitis, preserved erythropoietin and vitamin D production, middle molecule clearance, lower Left Ventricular Hypertrophy, and better serum phosphate level. The most practical method of assessing RKF is the mean of 24-h urinary urea and creatinine clearance. Incremental PD prescription is an ideal option to supplement RKF in PD patients, which also offers more flexibility to the patient and, possibly, improved adherence. Angiotensin converting enzyme inhibitors and angiotensin receptor blockers should be used when possible in PD patients to preserve RKF. Loop diuretics are underutilized in PD patients despite providing an additional means of maintaining fluid balance and reducing the need for higher glucose-containing PD solutions. In this paper, we outline the importance of RKF in PD patients and the different strategies for its preservation.
摘要：
残余肾功能（RKF）与更好的生存率相关。发病率较低，并改善腹膜透析（PD）患者的生活质量。由于更高的腹膜间隙不会导致更好的结果，应更加重视保护肾功能。据报道，许多其他好处，包括更好的容量和血压控制，营养状况更好，PD腹膜炎的发病率较低，保存的促红细胞生成素和维生素D的生产，中间分子清除，下左心室肥厚,和更好的血清磷酸盐水平。评估RKF的最实用方法是24小时尿尿素和肌酐清除率的平均值。递增PD处方是补充PD患者RKF的理想选择，这也为患者提供了更大的灵活性，可能,提高依从性。在PD患者中，应尽可能使用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂以保留RKF。尽管提供了维持体液平衡和减少对含更高葡萄糖的PD溶液的需要的额外手段,但在PD患者中环状利尿剂未得到充分利用。在本文中,我们概述了RKF在PD患者中的重要性以及保留RKF的不同策略.
