한국인 성인 지속성 외래 복막투석 환자에서 복막평형검사

Abstract

In order to evaluate the peritoneal transport cha- racteristics in Korean non-diabetic and diabetic end- stage renal disease patients, peritoneal equilibration test(PET) proposed by Twardowski et al. Were pe- rformed on patients who had been on continuous ambulatory peritoneal dialysis(CAPD) for 2 to 6 months. The results were as follows: 1) Fifty four patients(including 24 diabetics) on CAPD were studied with a mean age of 48.7 years. And male/female ratio was 1: 1.08 2) In nondiabetics, the dialysate to dialysate prior to infusion ratio for glucose(D/DO glu) at 2-, and 4-hour dwell times were 0.61±0.09, and 0.39±0.10, and the dialysate-to-plasma ratio for creatinine (D/P cr) at 2 , and 4-hour dwell times were 0.40± 0.11, 0.63±0.12, respectively. 3) In diabetic patients, D/DO glu at 2 , and 4- hour dwell times were 0.60±0.09, 0.39±0.08, respec- tively, and D/P cr at same dwell times were 0.50±0.08, and 0.71±0.08, which were significantly higher than in non-diabetics(p<0.05). 4) According to the two-hour plasma glucose co- ncentration, diabetic patients were subdivided into hy- perglycemic( >= 150mg/dL) and normoglycemic(<150mg/ dL) patients. The values of D/Pcr at 2 , and 4 hour dwell times in hyper-glycemic patients were signficantly higher than in non-diabetic patients (D2/P2 cr ' 0.50±0.09 vs. 0.40±0.11, D4/P4 cr: 0.72± 0.07 vs 0.63±0.12, respectively, p<0.05). 5) Net ultrafiltration did not differ between any of subgroups. 6) In non-diabetic patients, the ranges of D4/P4 cr and D4/DO glu for high, high average, low ave- rage, and low transporters were defined as D4/P4 cr: 0.87-0.75, 0.75-0.63, 0.63-0.51, 0.51-0.39, D4/DO glu :' 0.19-0.29 0.29-0.39, 0.39-0.49, 0.49-0.59, respectively, which were remarkably simliar as suggested by Twardowski et al. In conclusion, the creatinine and glucose transfers assessed by dialysateplasma ratio of creatinine and glucose are remarkably similar between Korean and North American patients. And the creatinine transport rate in Korean diabetic patient is higher than nondiabetic patient while ultrafiltration is achievable in nondiabetic patient.