UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate®

持续腹膜透析的非感染性并发症

Authors
Jean L Holley, MD, FACP
Rebecca J Schmidt, DO, FACP
Section Editor
Thomas A Golper, MD
Deputy Editors
Alice M Sheridan, MD
Kathryn A Collins, MD, PhD, FACS
Translators
徐安平, 主任医师，教授

引言

发生于持续腹膜透析[例如持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis, CAPD)、持续循环腹膜透析(continuous cycler peritoneal dialysis, CCPD)]患者的部分非感染性并发症是由于透析液灌入腹膜腔引起腹内压增高。这些并发症包括疝形成、渗漏(胸腔积液或胸腹膜漏)、局部水肿、背部疼痛，以及胃肠道问题如胃食管(gastroesophageal, GE)反流和胃排空延迟(参见“持续性腹膜透析中的腹壁疝”和“腹膜透析管的非感染性并发症”)。与腹内压无特定关联的CAPD/CCPD并发症包括腹腔积血、透析液灌入过程中疼痛、电解质紊乱，以及超滤失败。

本文将总结其中一些并发症，包括：

●胃食管反流和胃排空延迟

●背部和腹部疼痛

●胸腔积液

                      

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: 2017-06 . | This topic last updated: 2016-01-15.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
References
Top
  1. Björvell H, Hylander B. Functional status and personality in patients on chronic dialysis. J Intern Med 1989; 226:319.
  2. Dong R, Guo ZY. Gastrointestinal symptoms in patients undergoing peritoneal dialysis: multivariate analysis of correlated factors. World J Gastroenterol 2010; 16:2812.
  3. Hylander BI, Dalton CB, Castell DO, et al. Effect of intraperitoneal fluid volume changes on esophageal pressures: studies in patients on continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1991; 17:307.
  4. Kim MJ, Kwon KH, Lee SW. Gastroesophageal reflux disease in CAPD patients. Adv Perit Dial 1998; 14:98.
  5. Keshavarzian A, Iber FL, Vaeth J. Gastric emptying in patients with insulin-requiring diabetes mellitus. Am J Gastroenterol 1987; 82:29.
  6. Brown-Cartwright D, Smith HJ, Feldman M. Gastric emptying of an indigestible solid in patients with end-stage renal disease on continuous ambulatory peritoneal dialysis. Gastroenterology 1988; 95:49.
  7. Bird NJ, Streather CP, O'Doherty MJ, et al. Gastric emptying in patients with chronic renal failure on continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 1994; 9:287.
  8. Fernström A, Hylander B, Grybäck P, et al. Gastric emptying and electrogastrography in patients on CAPD. Perit Dial Int 1999; 19:429.
  9. Seibert DG, Moss AH, Holley JL, Foulks CJ. Intraperitoneal metoclopramide improves symptoms of gastroparesis in a CAPD patient. Perit Dial Int 1989; 9:223.
  10. Moss AH. Therapy for diabetic gastroparesis. Semin Dial 1991; 4:125.
  11. Wadhwa NK, Atkins H, Cabralda T. Intraperitoneal erythromycin for gastroparesis. Ann Intern Med 1991; 114:912.
  12. Gallar P, Oliet A, Vigil A, et al. Gastroparesis: an important cause of hospitalization in continuous ambulatory peritoneal dialysis patients and the role of erythromycin. Perit Dial Int 1993; 13 Suppl 2:S183.
  13. Amin K, Bastani B. Intraperitoneal ondansetron hydrochloride for intractable nausea and vomiting due to diabetic gastroparesis in a patient on peritoneal dialysis. Perit Dial Int 2002; 22:539.
  14. Al-Hwiesh A, Al-Mueilo S, Saeed I, Al-Muhanna FA. Intraperitoneal pressure and intra-abdominal pressure: are they the same? Perit Dial Int 2011; 31:315.
  15. Dejardin A, Robert A, Goffin E. Intraperitoneal pressure in PD patients: relationship to intraperitoneal volume, body size and PD-related complications. Nephrol Dial Transplant 2007; 22:1437.
  16. Bargman JM. Complications of peritoneal dialysis related to increased intraabdominal pressure. Kidney Int Suppl 1993; 40:S75.
  17. Homodraka-Malis A. Pathogenesis and treatment of back pain in peritoneal dialysis patients. Perit Dial Bull 1983; 3(Suppl 3):S41.
  18. Nomoto Y, Suga T, Nakajima K, et al. Acute hydrothorax in continuous ambulatory peritoneal dialysis--a collaborative study of 161 centers. Am J Nephrol 1989; 9:363.
  19. García Ramón R, Carrasco AM. Hydrothorax in peritoneal dialysis. Perit Dial Int 1998; 18:5.
  20. Lew SQ. Hydrothorax: pleural effusion associated with peritoneal dialysis. Perit Dial Int 2010; 30:13.
  21. Abraham G, Shokker A, Blake P, Oreopoulos DG. Massive hydrothorax in patients on peritoneal dialysis: A literature review. Adv Perit Dial 1988; 4:121.
  22. Shemin D, Clark DD, Chazan JA. Unexplained pleural effusions in the peritoneal dialysis population. Perit Dial Int 1989; 9:143.
  23. Fletcher S, Turney JH, Brownjohn AM. Increased incidence of hydrothorax complicating peritoneal dialysis in patients with adult polycystic kidney disease. Nephrol Dial Transplant 1994; 9:832.
  24. Christidou F, Vayonas G. Recurrent acute hydrothorax in a CAPD patient: successful management with small volumes of dialysate. Perit Dial Int 1995; 15:389.
  25. Simmons LE, Mir AR. A review of management of pleuroperitoneal communication in five CAPD patients. Adv Perit Dial 1989; 5:81.
  26. Sudduth CD, Sahn SA. Pleurodesis for nonmalignant pleural effusions. Recommendations. Chest 1992; 102:1855.
  27. Hidai H, Takatsu S, Chiba T. Intrathoracic instillation of autologous blood in treating massive hydrothorax following CAPD. Perit Dial Int 1989; 9:221.
  28. Kanaan N, Pieters T, Jamar F, Goffin E. Hydrothorax complicating continuous ambulatory peritoneal dialysis: successful management with talc pleurodesis under thoracoscopy. Nephrol Dial Transplant 1999; 14:1590.
  29. Szeto CC, Chow KM. Pathogenesis and management of hydrothorax complicating peritoneal dialysis. Curr Opin Pulm Med 2004; 10:315.
  30. Pattison CW, Rodger RS, Adu D, et al. Surgical treatment of hydrothorax complicating continuous ambulatory peritoneal dialysis. Clin Nephrol 1984; 21:191.
  31. Vaamonde CA, Michael UF, Metzger RA, Carroll KE Jr. Complications of acute peritoneal dialysis. J Chronic Dis 1975; 28:637.
  32. Mactier RA, Sprosen TS, Gokal R, et al. Bicarbonate and bicarbonate/lactate peritoneal dialysis solutions for the treatment of infusion pain. Kidney Int 1998; 53:1061.
  33. Bunchman TE, Ballal SH. Treatment of inflow pain by pH adjustment of dialysate in peritoneal dialysis. Perit Dial Int 1991; 11:179.
  34. Tranaeus A. A long-term study of a bicarbonate/lactate-based peritoneal dialysis solution--clinical benefits. The Bicarbonate/Lactate Study Group. Perit Dial Int 2000; 20:516.
  35. Khan AN, Bernardini J, Johnston JR, Piraino B. Hypokalemia in peritoneal dialysis patients. Perit Dial Int 1996; 16:652.
  36. Oreopoulos DG, Khanna R, Williams P, Vas SI. Continuous ambulatory peritoneal dialysis - 1981. Nephron 1982; 30:293.
  37. Spital A, Sterns RH. Potassium supplementation via the dialysate in continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1985; 6:173.
  38. Tziviskou E, Musso C, Bellizzi V, et al. Prevalence and pathogenesis of hypokalemia in patients on chronic peritoneal dialysis: one center's experience and review of the literature. Int Urol Nephrol 2003; 35:429.
  39. Bargman, JM. Noninfectious complications of peritoneal dialysis. In: The Textbook of Peritoneal Dialysis, Gokal, R, Nolph, KD (Eds), Kluwer, Boston 1994. p.555.
  40. Amirmokri P, Morgan P, Bastani B. Intra-peritoneal administration of potassium and magnesium: a practical method to supplement these electrolytes in peritoneal dialysis patients. Ren Fail 2007; 29:603.
  41. Navarro JF, Mora C, García J, et al. Hypermagnesemia in CAPD. Relationship with parathyroid hormone levels. Perit Dial Int 1998; 18:77.
  42. Hutchinson AJ. Serum magnesium and end-stage renal disease. Perit Dial Int 1997; 17:327.