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

腹膜透析用于治疗急性肾损伤(急性肾衰竭)

Author
Thomas A Golper, MD
Section Editor
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD
Translators
万建新, 主任医师，教授

引言

急性肾损伤(acute kidney injury, AKI)患者的治疗需要密切关注液体、酸碱和电解质平衡，以及尿毒症毒素的清除。腹膜透析(peritoneal dialysis, PD)是一种被忽视的AKI透析支持技术，因为PD主要用于治疗终末期肾病(end-stage renal disease, ESRD)患者。尽管如此，急性PD仍是特定AKI患者一种可行的治疗选择，特别是对于血流动力学受损或存在严重凝血异常的患者，或者当其他方法不易使用时[1-3]。

急性PD的优点、适应证和禁忌证，以及急性PD处方的组成将总结在此。急性肾衰竭(acute renal failure, ARF)的透析指征，以及血液透析(hemodialysis, HD)或连续性肾脏替代疗法的使用将单独讨论。 (参见“急性肾损伤(急性肾衰竭)的肾脏替代疗法(透析)：肾功能的恢复和血液透析膜的影响”和“连续性肾脏替代疗法在急性肾损伤(急性肾衰竭)中的应用”)

优点

与其他可用方法相比， PD作为肾脏替代疗法用于ARF患者时具有一些优点：

●PD广泛可用，技术上也易于实施

●血流动力学不稳定的患者使用PD能够移除大量液体；这种液体移除也可能有利于给予胃肠外营养

                                                                 

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: 2016-01-14.
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. Ash SR, Bever SL. Peritoneal dialysis for acute renal failure: the safe, effective, and low-cost modality. Adv Ren Replace Ther 1995; 2:160.
  2. Passadakis P, Oreopoulos D. Peritoneal dialysis in acute renal failure. Int J Artif Organs 2003; 26:265.
  3. Gabriel DP, Nascimento GV, Caramori JT, et al. High volume peritoneal dialysis for acute renal failure. Perit Dial Int 2007; 27:277.
  4. Nolph KD. Peritoneal dialysis for acute renal failure. ASAIO Trans 1988; 34:54.
  5. Alexander SR, Balfe JW, Harvey E. Peritoneal dialysis in children. In: The Textbook of Peritoneal Dialysis, Gokal R, Nolph KD (Eds), Kluwer Academic Publishers, Dordrecht 1994. p.591.
  6. Ehrich JH. Acute renal failure in infants and children. Int J Artif Organs 1996; 19:121.
  7. Brown ST, Ahearn DJ, Nolph KD. Potassium removal with peritoneal dialysis. Kidney Int 1973; 4:67.
  8. Cameron JS, Ogg C, Trounce JR. Peritoneal dialysis in hypercatabolic acute renal failure. Lancet 1967; 1:1188.
  9. Lamiere N. Principles of peritoneal dialysis and its application in acute renal failure. In: Critical Care Nephrology, Ronco C, Bellomo R (Eds), Kluwer Academic Publishers, Dordrecht 1998. p.1357.
  10. Posen GA, Luisello J. Continuous equilibration peritoneal dialysis in the treatment of acute renal failure. Perit Dial Bull 1980; 1:6.
  11. Kartirtzoglou A, Kontesis P, Myopoulou-Symvoulidis D, et al. Continuous equilibration peritoneal dialysis in hypercatabolic renal failure. Perit Dial Bull 1983; 3:178.
  12. Steiner RW. Continuous equilibration peritoneal dialysis in acute renal failure. Perit Dial Int 1989; 9:5.
  13. Juergensen PH, Murphy AL, Pherson KA, et al. Tidal peritoneal dialysis to achieve comfort in chronic peritoneal dialysis patients. Adv Perit Dial 1999; 15:125.
  14. Jiang L, Zeng R, Yang K, et al. Tidal versus other forms of peritoneal dialysis for acute kidney injury. Cochrane Database Syst Rev 2012; :CD007016.
  15. Amerling R, Glezerman I, Savransky E, et al. Continuous flow peritoneal dialysis: principles and applications. Semin Dial 2003; 16:335.
  16. Ash SR. Peritoneal dialysis in acute renal failure of adults: the under-utilized modality. Contrib Nephrol 2004; 144:239.
  17. Wong SN, Geary DF. Comparison of temporary and permanent catheters for acute peritoneal dialysis. Arch Dis Child 1988; 63:827.
  18. Kronfol NO. Acute peritoneal dialysis prescription. In: Handbook of Dialysis, 2nd ed., Daugirdas JT, Ing TS (Eds), Little, Brown and Company, 1994. p.301.
  19. Twardowski ZJ, Nolph KD. Blood purification in acute renal failure. Ann Intern Med 1984; 100:447.
  20. Chadha V, Warady BA, Blowey DL, et al. Tenckhoff catheters prove superior to cook catheters in pediatric acute peritoneal dialysis. Am J Kidney Dis 2000; 35:1111.
  21. Rubin J, Adair C, Barnes T, Bower J. Dialysate flow rate and peritoneal clearance. Am J Kidney Dis 1984; 4:260.
  22. Korbet, SM. Acute Peritoneal Dialysis Prescription. In: Handbook of Dialysis, 4th, Daugirdas, JT, Blake, PG, Ing, TS (Eds), Lippincott Williams & Wilkins, Philadelphia 2007. p.382.
  23. Vaamonde CA, Michael UF, Metzger RA, Carroll KE Jr. Complications of acute peritoneal dialysis. J Chronic Dis 1975; 28:637.
  24. Gault MH, Ferguson EL, Sidhu JS, Corbin RP. Fluid and electrolyte complications of peritoneal dialysis. Choice of dialysis solutions. Ann Intern Med 1971; 75:253.
  25. Passadakis P, Malliara M, Thodis E, et al. Arterial hypotension in patients on peritoneal dialysis. Int J Artif Organs 2002; 25:489.
  26. Chionh CY, Soni SS, Finkelstein FO, et al. Use of peritoneal dialysis in AKI: a systematic review. Clin J Am Soc Nephrol 2013; 8:1649.
  27. Phu NH, Hien TT, Mai NT, et al. Hemofiltration and peritoneal dialysis in infection-associated acute renal failure in Vietnam. N Engl J Med 2002; 347:895.
  28. Daugirdas JT. Peritoneal dialysis in acute renal failure--why the bad outcome? N Engl J Med 2002; 347:933.