连续性不卧床腹膜透析治疗艾滋病并发终末期肾脏病(附一例报道)  

Continuous ambulatory peritoneal dialysis in AIDS patients with ESRD—Case report

作　　者：谢静远[1] 冯晓蓓[1] 卢洪洲[2] 齐唐凯[2] 沈平雁[1] 黄晓敏[1] 陈楠[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院肾脏科 [2]上海市公共卫生临床中心感染科,上海200025

出　　处：《肾脏病与透析肾移植杂志》2007年第6期522-527,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：上海市重点学科基金(T0201);上海市卫生局重点学科基金(05Ⅲ001);上海市卫生局重点课题(2003ZD002)

摘　　要：目的:观察连续性不卧床腹膜透析(CAPD)对艾滋病(acquired immunodeficiency syndrome,AIDS)并发终末期肾脏病(ESRD)的疗效。方法:一例确诊为艾滋病的男性患者,合并慢性丙型肝炎、血友病甲(Ⅷ因子缺乏)和糖尿病,高效抗逆转录病毒治疗(HAART)1年后出现蛋白尿及肾功能不全,进展至ESRD后行CAPD治疗,观察CAPD前后残余肾功能、贫血、钙磷代谢、心功能、营养状况等变化,并进行透析充分性及并发症评估。结果:患者行CAPD治疗后高血压、贫血、氮质血症、酸中毒及心功能均明显改善,体重稳定,无水肿,Kt/V2.01/周,nPCR1.133g/(kg.d)。存在营养不良-炎症-心血管疾病综合征及代谢紊乱。结论:AIDS并发ESRD行CAPD作为肾脏替代治疗可取得满意疗效。Objective ：Continuous ambulatory peritoneal dialysis （CAPD） has been advocated as a therapeutic approach to patients with acquired immunodeficiency syndrome（AIDS） complicated with end stage renal disease （ESRD）, In this study, one case of AIDS with ESRD treated with CAPD was reported. Methodology ： One patient of AIDS complicated with chronic hepatitis C,hemophilia A （lack of factor Ⅷ） ,diabetic mellitus （DM） ,proteinuria and chronic renal failure happened after one year of highly active antiretroviral therapy （HAART）. We started to performed peritoneal dialysis when the patient reached ESRD. The residual renal function, anemia, calcium and phosphorus disorder, heart function and malnutrition before and after CAPD were measured, and the general status after 8 months of peritoneal dialysis was estimated. Results：After CAPD, the hypertension, anemia, uremia, acidosis and heart dysfunction were improved remarkably. The patient felt comfortable, and had good appetite, stable weight and no edema. Kt/V was 2. 01/w, nPCR was 1. 133 g/（ kg· d）. But MIA syndrome and metabolic disorder was also existed. Conclusion：CAPD is an effective treatment in AIDS complicated with ESRD.

关 键 词：艾滋病 人类免疫缺陷病毒 终末期肾病 血液净化 

分 类 号：R459.5[医药卫生—治疗学] R512.91[医药卫生—临床医学]