Kt/V或二碳酸盐:在儿科腹腔透析患者的生长中,哪个更重要?
Lucimary de Castro Sylvestre1,2, Rejane de Paula Bernardes3, Débora Stremel Ribeiro4
1Division of Pediatric Nephrology, Department of Pediatrics, Hospital Pequeno Príncipe, Curitiba, Brazil.
Blood purification
|May 26, 2023
概括
腹腔透析 (PD) 治疗的儿童慢性病患者没有表现出改善的生长与增加透析充分性. 将二碳酸盐水平正常化可能是改善PD儿童身高的关键.
科学领域:
- 儿科脏病学 儿科脏病学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 增长迟缓对于患有慢性病 (CKD) 的儿童来说是一个重大挑战.
- 增强腹膜透析 (PD) 对儿科慢性病患者生长的影响尚不清楚.
研究的目的:
- 调查腹膜透析充分性参数与儿童生长结果之间的关系.
- 确定增加透析是否可以增加患有CKD的儿科患者的生长.
主要方法:
- 一项对53名患有PD的儿童 (27名男性) 的纵向研究,使用身高标准偏差分数 (SDS) 和生长速度z-score来评估生长.
- 在9个月间隔进行了两次充分性测试,将腹腔内压力和KDOQI指南与生长指标进行了比较.
- 使用单变量和多变量分析来确定相关性.
主要成果:
- 平均每周的Kt/V和肌素清除率高于之前的儿科研究.
- 在身高SDS或生长速度z-score和透析充分性参数 (如Kt/V或肌素清除) 之间没有发现显著的相关性.
- 增长的改善 (三角形高度SDS) 与年龄,二碳酸盐水平和腹腔内压力有关.
结论:
- 增加腹腔透析充分性 (Kt/V,肌素清除率) 并没有直接改善儿科慢性病患者的生长.
- 血清二碳酸盐度的正常化被强调为改善这些患者身高z-score的关键因素.
相关概念视频
Peritoneal Dialysis I: Introduction and Procedure
67
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
67
Peritoneal Dialysis III: Nursing Management
58
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
58
Chronic Kidney Disease III: Interprofessional Care
54
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
54
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
48
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
48
Acute Kidney Injury V: Interprofessional Care
30
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
30
Roles of Electrolytes: Chloride and Bicarbonate
282
Chloride ions contribute to the osmotic pressure gradient distinguishing the intracellular fluid (ICF) from the extracellular fluid (ECF). They counterbalance positively charged ions in the ECF and ensure its electrochemical stability. The renal system's process of chloride absorption and release generally mirrors that of sodium ions.
Conditions such as hypochloremia can arise from insufficient chloride reabsorption by the kidneys, often compounded by extended bouts of diarrhea, vomiting,...
Conditions such as hypochloremia can arise from insufficient chloride reabsorption by the kidneys, often compounded by extended bouts of diarrhea, vomiting,...
282


