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Clinical relevance of marginal factors on ultrafiltration in peritoneal dialysis.

边际因素对腹膜透析超滤的临床相关性。

  • 影响因子:1.32
  • DOI:10.1177/0896860820904556
  • 作者列表:"Pérez-Díaz V","Pérez-Escudero A","Sanz-Ballesteros S","Sánchez-García L","Hernández-García E","Oviedo-Gómez V","Sobrino-Pérez A
  • 发表时间:2021-01-01
Abstract

BACKGROUND:Ultrafiltration (UF) in peritoneal dialysis (PD) is mainly driven by the osmotic gradient and peritoneal permeability, but other factors-such as intraperitoneal pressure (IPP)-also have an influence. METHODS:To assess the clinical relevance of these marginal factors, we studied 41 unselected PD patients undergoing two consecutive 2 h, 2.27% glucose exchanges, first with 2.5 L and then with 1.5 L. RESULTS:IPP, higher in the 2.5 L exchange, had a wide interpatient range, was higher in obese and polycystic patients and their increase with infusion volume was higher for women regardless of body size. UF with 2.5 L correlated inversely with IPP and was higher for patients with polycystosis or hernias, while for 1.5 L we found no significant correlations. The effluent had higher glucose and osmolarity in the 2.5 L exchange than in the 1.5 L one, similar for both sexes. In spite of this stronger osmotic gradient, only 21 patients had more UF in the 2.5 L exchange, with differences up to 240 mL. The other 20 patients had more UF in the 1.5 L exchange, with stronger differences (up to 800 mL, and more than 240 mL for 9 patients). The second group, with similar effluent osmolarity and peritoneal equilibration test (PET) parameters than the first, has higher IPP and preponderance of men. The sex influence is so intense that men decreased average UF with 2.5 L with respect to 1.5 L, while women increased it. CONCLUSIONS:With 2.27% glucose, sex and IPP-modulated by obesity, polycystosis, hernias, and intraperitoneal volume-significantly affect UF in clinical settings and might be useful for its management.

摘要

背景: 腹膜透析 (PD) 超滤 (UF) 主要受渗透梯度和腹膜通透性的驱动,但其他因素如腹腔压力 (IPP) 也有影响。 方法: 为了评估这些边缘因素的临床相关性,我们研究了41名未经选择的PD患者,他们接受了连续两次2 h,2.27% 次葡萄糖交换,首先是2.5 L,然后是1.5 L。 结果: IPP,在2.5 L交换中较高,具有广泛的患者间范围,在肥胖和多囊性患者中较高,并且无论身体大小,女性随着输液量的增加而增加。2.5 L的UF与IPP呈负相关,对于多囊症或疝气患者更高,而对于1.5 L,我们没有发现显著的相关性。流出物在2.5升交换中具有比在1.5升交换中更高的葡萄糖和渗透压,两性相似。尽管有这种更强的渗透梯度,但只有21名患者在2.5 L交换中具有更多的UF,差异高达240 mL。其他20例患者在1.5 L交换中UF更多,差异更强 (高达800 mL,9例患者超过240 mL)。第二组具有与第一组相似的流出物渗透压和腹膜平衡测试 (PET) 参数,具有更高的IPP和男性优势。性别影响如此强烈,以至于男性平均UF降低了2.5 L,而女性则增加了1.5 L。 结论: 2.27% 的葡萄糖、性别和IPP受肥胖、多囊症、疝和腹腔容积的调节,在临床环境中显著影响UF,并可能对其管理有用。

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