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连续腹膜透析中溶质清除和超滤问题的探讨

Authors
John M Burkart, MD
William L Henrich, MD, MACP
Section Editor
Thomas A Golper, MD
Deputy Editor
Alice M Sheridan, MD
Translators
张浩, 主任医师，教授

引言

长期腹膜透析[包括持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis, CAPD)及自动腹膜透析(automated peritoneal dialysis, APD)如持续循环腹膜透析(continuous cycler peritoneal dialysis, CCPD)]患者有时难以达到溶质清除的目标或维持血容量正常。溶质清除不充分和容量超负荷均存在多种病因。

本专题将总结在腹膜透析患者中引起溶质清除不充分的因素，并将讨论特定溶质的清除问题。本专题也将总结腹膜透析患者中容量超负荷的问题，并将提供一种评估此类患者的方法。

调节溶质和水跨腹膜转运的因素将单独讨论。 (参见“腹膜透析溶质清除和超滤的机制”)

下文中的讨论均假定：在腹膜透析中，最初溶质和/或液体的清除是充足的，随着时间的推移其清除逐渐受损。对在开始透析时必须考虑的因素的系统评价参见其他专题。 (参见“长期腹膜透析方式的选择”)

定义

在腹膜透析患者中，总的溶质移除或清除包括通过透析和残余肾清除对相关溶质进行清除。特定溶质的清除率经常用作衡量透析剂量的一个指标；在这种情况下，术语清除率指单位时间内“清除”含某种物质的血液量。透析量或清除率同样可通过将血液中特定溶质分布(即溶质清除)的体积进行标准化后表示，例如Kt/V。

                

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Literature review current through: 2017-06 . | This topic last updated: 2016-09-01.
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