Electrolyte changes and dialysis adequacy in patients underwent continued ambulatory peritoneal dialysis for 1 month / 中国综合临床

ABSTRACT

Objective To investigate the impact of continued ambulatory peritoneal dialysis (CAPD)for 1 month,thus to provide effective therapy to control the symptoms of uremia in early stage. Methods A total of 129 nephrotic patients in final stage were treated with CAPD ,dialysis adequacy were assessed after 1 month of CAPD. Complications and biochemical indicators were compared between before and after 1 month of CAPD. Results The dialysis adequacy was good at the end of 1 month of CAPD. Compared to before CAPD,The prevalence of edema after 1 month of CAPD significantly decreased compared to before CAPD (7.8%vs. 24.8% ,χ2 = 13.765, P ＜ 0.05 ). After CAPD gastrointestinal, symptom, such as nausea and vomit significantly decreased from 66.7% to 6. 2% ( χ2 = 101. 821, P ＜ 0. 05 ). Itch of skin significantly decreased from 22. 5% before CAPD to 6. 2% after CAPD(χ2 = 13.914,P ＜0. 05) . Hemoglobin increased significantly from (79. 10 ± 17.13 ) g/L to (96. 50 ± 18. 69 ) g/L after CAPD ( t = - 6. 333, P ＜ 0. 01 ), serum calcium was sisilar, ( 1.99 ± 0.30) mmol/L and (2.07 ± 0. 20) mmol/L at before and after CAPD respectively ( t = -1. 920,P ＞0. 05). Albumin was (30. 62 ±5.24) g/L before CAPD and after CAPD(31.84 ±5.64) g/L ,with no significant difference ( t= - 0.333, P ＞ 0. 05 ) . Serum inorganic phosphorus, kalemia, urea nitrogen and creatinine concentration significantly decreased from ( 2. 06 ± 0. 54 ) mmol/L, ( 4.30 ± 0. 68 ) mmol/L, 22. 00( 15.87,30.03 ) mmol/L and 864. 00 ( 733.00,1046. 25 ) μmol/L to ( 1.72 ± 0. 52) mmol/L, ( 3.84 ± 0.47 )mmol/L , 17.00 ( 13.91,20. 91 ) mmol/L and 777. 50 ( 627.00, 1047.75 ) μnol/L, respectively ( t = 3.284,4. 669, Z = - 3.717 and - 2. 408, respectively,Ps ＜ 0. 01 or 0. 05 ).. The level of serum PTH increased slightly from [ 184. 80 ( 114. 21,369. 77) ng/L to 226. 26 ( 124. 22,335.92 ) ng/L, but the difference was not significant ( Z = - 0. 597, P ＞ 0. 05 ). Conclusion CAPD had significant effect in early stage of dialysis with good dialysis adequacy. Hypocalcemia and hyperphosphatemia can be improved. The levels of serum kalemia decreased. The iatients's quality of life significantly improved.