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| 복수가 있는 만성 신부전 환자에서의 복막 투석 |
| 윤성노 , 양철우 , 이승헌 , 최의진 , 장윤식 , 방병기 |
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| Abstract |
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We evaluated the seven chronic renal failure pa- tients who suffered from chronic ascites and treated with CAPD. The mean age was 43.0±11.2 years and the mean observation duration was 52.3±25.1 weeks. The causes of ascites were chronic liver di- sease in three patients and hemodialysis associated process(idiopathic acsites) in two patients and heart failure in one patient. In one patient reversion to hemodialysis was needed due to intractable pleural effusion at one month after peritoneal dialysis(PD). We studied peritoneal equilibration test(PET) in all patients and compaired D/DO glucose ratio, D/P creatinine ratio and drainage volume. And we stu- died serum albumin serially as a nutritional marker except pateint who revert to hemodialysis due to pleural effusion. In all patients the solute transfer rate, I.e. D/DO glucose ratio and D/P creatinine ratio, was accurately consistent with each other and was high average or high transport rate. The drainage volume was inconsistent with the solute transport rate and corresponded to the area of low or low- average transport in five patients. In two patients PET showed high average transport rate and drai- nage volume corresponding to same transport area. There was no patient who manifested ultrafiltration failure during observation period. Serum albumin was nadir at 1 month postPD and gradually in- creased after three rnonth. At ten to twelve month after PD, albumin level approached to or exceed that of prePD state in five pateints. One pateint who was diabetic and cornplicated by heart failure showed progressive decrease of serum albumin and poor clinical course. In conclusion, CAPD was a good tool to manage the ascites in ESRD with adequate solute clearance and without ultrafiltration failure. |
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