在腹腔透析中,随着时间的推移,腹膜蛋白质的损失
Anabela Malho Guedes1,2, Roberto Calças Marques1, Ana Teresa Domingos1
1Serviço de Nefrologia, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
Seminars in dialysis
|February 29, 2024
概括
在大多数腹膜透析患者中,腹膜蛋白质损失 (PPL) 随着时间的推移保持稳定. 然而,在PD治疗四年后,PPL下降,这表明PD持续时间对蛋白质泄漏没有有害影响.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 腹膜透析研究 腹膜透析研究
- 功能研究 功能研究
背景情况:
- 腹内蛋白损失 (PPL) 是腹内透析 (PD) 期间腹内膜功能的关键指标.
- 在PPL的纵向变化及其与腹膜随时间变化的结构变化相关的关系在PD并未得到充分理解.
- 潜在的结构变化包括介质细胞损失,血管病变和亚介质纤维化,这可能会影响蛋白质泄漏.
研究的目的:
- 在接受腹膜透析 (PD) 的患者中,研究腹膜蛋白损失 (PPL) 的纵向变化.
- 为了确定与延长PD治疗相关的结构变化是否会导致增加PPL或改变溶液运输.
- 评估时间对PD的影响,包括膜特征和患者参数.
主要方法:
- 一个单一中心的纵向研究包括52名PD患者,随访时间中位数为26.5个月.
- 患者在两个时间点进行评估,间隔至少6个月.
- 用重复测量分析,包括配对样本t测试或Wilcoxon签名等级测试,来分析PPL,D/P肌素和其他参数的变化.
主要成果:
- 在PD治疗中位数为15.5个月后,残留功能和尿量下降,但D/P肌和PPL保持稳定. 观察到超过的减少.
- 在一个被跟踪超过48个月的子群体中 (n=11),PPL显著下降 (平均差异1.2g/24h,p=0.033),而炎症,营养和水分参数与基线没有显著变化.
- D / P 肌和滴保持不变,表明保存的溶液运输和液体去除能力.
结论:
- 在大多数患者中,PD的时间并没有导致腹蛋白损失 (PPL) 的逐渐增加,这对PD治疗来说是令人放心的.
- 在使用PD超过四年后,观察到PPL的显著下降,这表明更新PD处方和生物相容解决方案的潜在益处.
- PPL可以作为获得的静脉血管病变的生物标志物,即使保留了小孔和自由水运输,强调监测膜完整性的重要性.
相关概念视频
Dialysis
309
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
309
Overview of Protein Metabolism
1.2K
Proteins are broken down into amino acids during digestion. Unlike fats and carbohydrates, which are stored for later use, proteins are not. Instead, amino acids are either used to produce ATP through oxidation or contribute to the creation of new proteins for the growth and repair of the body. Any surplus amino acids from the diet are converted into glucose or triglycerides rather than excreted.
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
1.2K
Renal Corpuscle
2.1K
The glomerulus and Bowman's capsule are two essential components of the nephron, which is the functional unit of the kidney. These microscopic structures play a critical role in the process of blood filtration to produce urine.
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
2.1K
Nephrons
2.4K
The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
2.4K
Pleural Effusion I: Introduction
980
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
980
Chronic Pancreatitis I: Introduction
89
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
89


