腹膜透析对终末期肾病患者铁蛋白清除的影响  

Serum ferritin clearance in diabetic peritoneal dialysis patients

作　　者：陆文琪 刘维萍[1] 刘海荣[1] 张彦芬[1] 苏娜[1] 魏鹍[1] Lu Wenqi;Liu Weiping;Liu Hairong;Zhang Yanfen;Wei Kun(Department of Nephrology,The First Hospital of Qinhuangdao,Qinhuangdao 066000,Chin)

机构地区：[1]河北省秦皇岛市第一医院,066000

出　　处：《国际移植与血液净化杂志》2018年第3期24-27,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的分析糖尿病终末期肾病患者行腹膜透析（peritoneal dialysis, PD）治疗，单次腹膜透析液铁蛋白清除情况，为改善糖尿病腹膜透析患者的贫血、营养状况及预后提供依据。方法选择我院2015年4月至2017年4月共64例腹膜透析患者，其中糖尿病终末期肾病组（diabetic nephropathy end-stage renal disease，DNESRD）26例，非糖尿病终末期肾病组（non-diabetic nephropathy end-stage renal disease，NDNESRD）38例。检测透析前空腹血红蛋白（hemoglobin, Hb）、白蛋白（albumin, Alb）、血清铁蛋白（serum ferritin，SF）、血清铁（Fe）、转铁蛋白（transferring, TRF）、肌酐（creatinine, Cr）、血尿素氮（blood urea nitrogen, BUN）、甲状旁腺激素（parathyroid hormone, PTH）。检测透析后SF、Fe、TRF、Cr、BUN、PTH。计算Fe、TRF、Cr、BUN、PTH下降率（removal rate, RR）。记录腹膜透析引流量，检测透析引流液中SF浓度，并计算SF清除总量（total removal, TR）。结果两组KT/V、透析前后转铁蛋白、尿素氮下降率差异有统计学意义（P〈0.05）。两组铁蛋白清除量差异无统计学意义（P〉0.05）。结论糖尿病终末期肾病组与非糖尿病终末期肾病组患者均可以通过腹膜透析清除铁蛋白，糖尿病终末期肾病组腹膜透析后血中转铁蛋白量减少更显著，这可能是糖尿病肾病患者行腹膜透析出现营养不良、贫血及影响预后的一个危险因素。Objective To improve the anemia, nutritional status and and prognosis of diabetic peritoneal dialysis patients, we explored serum ferritin （SF） clearance in single peritoneal dialysis in diabetic nephropathy end-stage renal disease peritoneal dialysis patients. Methods We recruited 64 patients with peritoneal dialysis from April 2015 to April 2017 in the First Hospital of Qinhuangdao. Among them, 26 cases were diabetics and the other cases were non-diabetics. Hemoglobin （Hb）, albumin （Alb）, SF, serum iron （Fe）, transferring （TRF）, creatinine （Cr）, blood urea nitrogen （BUN） and parathyroid hormone （PTH） were detected at pre-dialysis and post-dialysis. Removal rate （RR） of SF, Fe, TRF, Cr, BUN and PTH were calculated. We recorded the volume of collected dialysate, and detected the concentration of SF, Fe, TRF, Cr, BUN and PTH. Results KT/V, post-dialysis transferring, the removal rate （RR） of BUN showed statistically significant difference between the two groups （ P 〈 0.05 ）. There was no statistically significant difference of SF clearance between the two groups （ P 〉 0.05）. Conclusions Diabetic and non- diabetic group can lose SF from peritoneal dialysis solution, but there was no significant difference between two groups. Compared to the non-diabetic group, the decrease of transferrin after dialysis was more significant. This may be a risk factor for malnutrition, anemia and prognosis in diabetic peritoneal dialysis patients.

关 键 词：糖尿病 腹膜透析 铁蛋白 转铁蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]