临床荟萃

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腹膜透析患者残肾功能对血管内皮细胞功能的影响

  

  1. 江苏大学附属医院 肾内科,江苏 镇江 212001
  • 出版日期:2017-08-05 发布日期:2017-08-10
  • 通讯作者: 通信作者:司博林,Email:gansu8562@163.com
  • 基金资助:
    江苏大学医学临床科技发展基金(JLY20120152)

Relationship of residual renal function and endothelial dysfunction  in peritoneal dialysis patients

  1. Department of Nephrology, the Affiliated Hospital of Jiangsu University, Zhenjiang  212001,China
  • Online:2017-08-05 Published:2017-08-10
  • Contact: Corresponding author: Si Bolin, Email: gansu8562@163.com

摘要: 目的探讨影响腹膜透析患者血管内皮细胞功能的因素。方法选取45例腹膜透析患者为研究对象。收集2组患者的临床资料及实验室数据。采用血流介导的肱动脉扩张法(flowmediated diameter,FMD)来评估血管内皮细胞功能。采用肾脏尿素、肌酐清除率评估残肾功能。结果根据残肾肾小球滤过率(glomerular filtration rate,GFR)分为2组,A组(残肾GFR<1 ml/min),B组(残肾GFR>1 ml/min)。两组间血压、血红蛋白、血磷、甲状旁腺激素(PTH)、血清白蛋白、总胆固醇、甘油三酯,每周KT/V差异无统计学意义,而透析时间、FMD差异有统计学意义。相关分析示FMD与残肾GFR成正相关,与透析时间成负相关。多元逐步回归分析示残肾GFR是FMD独立的危险因素。结论腹膜透析患者残肾功能水平和血管内皮细胞功能相关,残肾功能下降是血管内皮细胞功能紊乱的独立危险因素。

关键词: 腹膜透析, 内皮细胞, 肾功能不全

Abstract: Objective  To elucidate factors of endothelial dysfunction for  patients with peritoneal dialysis.Methods  Fortyfive peritoneal dialysis patients in a single center were recruited. Demographic and clinical data were recorded. Residual glomerular filtration rate (GFR) was measured. Endothelial  function was assessed by brachial artery endotheliumdependent vasodilation(FMD). Renal urea and creatinine clearance were used to assess residual kidney function.Results  According to residual GFR,peritoneal dialysis patients were divided into two groups: group A   (residual GFR<1 ml/min), group B(residual GFR>1 ml/min). Blood pressure, hemoglobin, serum albumin, total cholesterol, triglyceride, serum P, PTH and weekly KT/V had no significant difference between group A  and group B(P>0.05). The FMD in group B was significantly higher than that in group A(P<0.05). Correlation analysis revealed that residual GFR was positively correlated with FMD, whereas PD duration was inversely correlated with FMD. In multivariate linear regression analysis, residual GFR was found to be an independent determinant of FMD(β=0.36,P=0.01).Conclusion  This study showed that the residual renal function was independently associated with endothelial dysfunction in patients with peritoneal dialysis.

 

Key words: peritoneal dialysis, endothelial cells, renal insufficiencyperitoneal dialysis, endothelial cells, renal insufficiency peritoneal dialysis, endothelial cells, renal insufficiency