基于icodextrin的连续动态腹膜透析治疗可有效降低终末期肾病患者左心室质量指数并保护心功能。

Ikuko Oba, Michiya Shinozaki, Kenji Harada, Takefumi Mori, Hidetoshi Kanai
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摘要

左心室质量指数(LVMI)升高在接受腹膜透析(PD)的患者中很常见。本研究旨在探讨icodextrin (Ico)对维持残肾功能(RRF) PD患者LVMI的影响。本回顾性研究纳入18例患者(男性12例,女性6例;平均年龄:62 +/- 10岁),诊断为PD治疗指征,分为两组:Ico组(Ico组)和未Ico组(非Ico组)。超声心动图分别在连续门诊PD开始时、6个月和12个月后进行。lco治疗6个月后LVMI显著降低(p < 0.01),超滤升高(p < 0.01),并维持12个月。12个月后,非Ico组的射血分数明显降低(p < 0.01),而Ico组没有变化。PD治疗12个月后血压、心胸比、尿量、脑利钠肽n端激素原均未受影响。年平均超滤与LVMI降低有显著相关(p < 0.05)。Ico有效改善终末期肾病患者PD起始1年内LVMI,维持射血分数。值得注意的是,Ico治疗导致LVMI降低(与超滤增加相关),而RRF没有显著降低。
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Icodextrin-based continuous ambulatory peritoneal dialysis therapy effectively reduces left ventricular mass index and protects cardiac function in patients with end-stage renal disease.

Increased left ventricular mass index (LVMI) is commonly observed in patients undergoing peritoneal dialysis (PD). The present study aimed to determine the effect of icodextrin (Ico) on LVMI in PD patients with maintained residual renal function (RRF). This retrospective study included 18 patients (12 men, 6 women; average age: 62 +/- 10 years) diagnosed with indications for PD therapy and divided into two groups: those treated with Ico (Ico group) and without Ico (non-Ico group). Echocardiography was performed at the beginning of continuous ambulatory PD and after 6 and 12 months. A significant reduction in LVMI (p < 0.01) and an increase in ultrafiltration (p < 0.01) were observed after 6 months of lco treatment and were maintained for 12 months. Ejection fraction was significantly lower in the non-Ico group after 12 months (p < 0.01), but was not altered in the Ico group. Blood pressure, cardiothoracic ratio, urine volume, and N-terminal prohormone of brain natriuretic peptide were unaffected by PD treatment up to 12 months. The year-averaged ultrafiltration and the reduction in LVMI were significantly correlated (p < 0.05). Ico effectively improved LVMI and maintained ejection fraction in end-stage renal disease patients within 1 year from PD initiation. Notably, treatment with Ico resulted in a reduction of LVMI (associated with increased ultrafiltration), with no significant reduction in RRF.

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