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儿童长期腹膜透析

Authors
Annabelle Chua, MD
Bradley A Warady, MD
Section Editor
Patrick Niaudet, MD
Deputy Editor
Melanie S Kim, MD

引言

长期腹膜透析(chronic peritoneal dialysis, CPD)是用于治疗终末期肾病(end-stage renal disease, ESRD)儿科患者(特别对于不到5岁的儿童)最常见的透析治疗方式[1-3]。CPD有几个利于儿童的、胜于血液透析(hemodialysis, HD)的优点；但是，在一些临床情况下，也存在CPD禁忌证或CPD可能并非是最好透析方式。此外，尽管CPD对于儿童和成人患者的原理相同，但对于儿童及婴幼儿，行CPD有特别需要注意的方面，以确保儿科患者透析充分，并减少并发症。

儿童CPD的各个方面将总结在此。儿童的肾脏替代治疗和慢性肾脏病(chronic kidney disease, CKD)儿童血液透析的概述参见其他专题。(参见“慢性肾脏病患儿肾脏替代疗法(RRT)概述”和“慢性肾病儿童的血液透析”)

成人和儿童患者中，CPD过程中去除溶质和液体的一般机制在相同，这也将单独讨论。(参见“腹膜透析溶质清除和超滤的机制”)

腹膜透析对比血液透析

目前尚无任何针对ESRD儿童患者腹膜透析和血液透析的结局的对比研究，也无法表明一种方法相对于另一种更具优势。虽然大多数需要透析的ESRD儿科患者可进行CPD治疗，但透析方式的选择最常根据患者及家属的偏好、医疗中心的理念和期望方式是否可及而定。

选择家庭透析治疗方式时，患者及家属的生存质量是一种很重要的因素，因为ESRD治疗方法会带来“治疗负担”。因此，如果要做出明智的决定，应对患者家庭的社会、心理及经济背景进行仔细评估，并且理想情况下应由多专业团队(包括家庭内科医生和肾病学家、透析护士、心理学家和社会工作者)进行评估[4,5]。

                              

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Literature review current through: 2017-06 . | This topic last updated: 2016-02-23.
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