Progress of research on the role of peritoneal dialysis in treatment of cardiorenal syndrome type Ⅰ and Ⅱ

doi:10.3877/cma.j.issn.2095-3216.2014.03.009

Abstract

Abstract:

Cardiorenal syndrome (CRS) is defined as a complex pathophysiological disorder manifested by both cardiac and renal dysfunctions with a high mobidity and a very complicated therapy. To alleviate the symptoms of congestive heart failure in patients with CRS type Ⅰand Ⅱ, diuretics and ultrafiltration are usually used in traditional therapy, although both of them have their limitations. In recent years, accumulating studies have indicated that peritoneal dialysis (PD) is an effective therapy in fluid removal, cardiac function improvement, and hospitalization reduction of patients with CRS typeⅠand Ⅱ.The present review mainly introduces the results of recent studies of PD therapy in CRS typeⅠandⅡ,with an emphasis on the efficacy, underlying mechanisms, and feasibility of PD.

Key words: Cardiorenal syndrome, Congestive heart failure, Blood ultrafiltration, Peritoneal dialysis

Shu Li, Zhaohui Ni. Progress of research on the role of peritoneal dialysis in treatment of cardiorenal syndrome type Ⅰ and Ⅱ[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2014, 03(03): 155-159.

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作者	人数	生存	住院	功能改善情况
Nakayama等^[24]	12(PD)	中位随访时间26个月,生存率为75%	＞3次/年(PD之前),PD之后无因心衰住院	NYHA分级从Ⅲ级(n=9)、Ⅳ级(n=3)降为Ⅰ级(n=9)、Ⅱ级(n=3)
Sotirakopoulos等^[26]	19(PD)	1年生存率为68%,2年生存率为42%	因液体潴留住院时间PD之前为5～20d/(月·人),PD之后为0	平均射血分数从28%升高到36%,体重下降5kg
Cnossen等^[27-28]	12(PD)	中位生存期为16个月	心脏疾病相关住院时间从1.4降为0.4d/(月·人)	NYHA分级从3.8降为2.7,生活质量改善,但机械并发症增多(HD=PD)
	11(HD)
Nunez等^[25,30]	28(PD)	PD降低了死亡风险:0.4(0.21～0.75)	开始PD6个月内84%的患者住院率减少	16个月总死亡率为63%,25例患者MLWHF评分、6分钟步行实验和NYHA分级改善(平均为1.04)
	12(对照)
Kunin等^[29]	37(PD)	中位生存期为14个月	“长期”生存患者住院率下降55%	“长期”生存患者需要使用的利尿剂减少,NYHA分级平均下降1级
Rizkallah等^[31]	10(PD)	?	住院时间从3.2d/(人·月)降为0.1d/(人·月),每次住院时间从37d降为0.78d	无法耐受移植。NYHA分级ⅢB级者心功能改善,对利尿剂的反应增强,体重下降7kg
Courivaud等^[32]	126(PD)	1年生存率为58%	住院时间从3.3d/(人·月)降为0.3d/(人·月)	左室射血分数增加
Bertoli等^[33]	48(PD)	1年生存率为85%,2年生存率为56%	年入院次数从43次降为11次	PD之前1年需要入院进行体外超滤治疗至少3次,PD之后无

作者	人数	生存	住院	功能改善情况
Nakayama等^[24]	12(PD)	中位随访时间26个月,生存率为75%	＞3次/年(PD之前),PD之后无因心衰住院	NYHA分级从Ⅲ级(n=9)、Ⅳ级(n=3)降为Ⅰ级(n=9)、Ⅱ级(n=3)
Sotirakopoulos等^[26]	19(PD)	1年生存率为68%,2年生存率为42%	因液体潴留住院时间PD之前为5～20d/(月·人),PD之后为0	平均射血分数从28%升高到36%,体重下降5kg
Cnossen等^[27-28]	12(PD)	中位生存期为16个月	心脏疾病相关住院时间从1.4降为0.4d/(月·人)	NYHA分级从3.8降为2.7,生活质量改善,但机械并发症增多(HD=PD)
	11(HD)
Nunez等^[25,30]	28(PD)	PD降低了死亡风险:0.4(0.21～0.75)	开始PD6个月内84%的患者住院率减少	16个月总死亡率为63%,25例患者MLWHF评分、6分钟步行实验和NYHA分级改善(平均为1.04)
	12(对照)
Kunin等^[29]	37(PD)	中位生存期为14个月	“长期”生存患者住院率下降55%	“长期”生存患者需要使用的利尿剂减少,NYHA分级平均下降1级
Rizkallah等^[31]	10(PD)	?	住院时间从3.2d/(人·月)降为0.1d/(人·月),每次住院时间从37d降为0.78d	无法耐受移植。NYHA分级ⅢB级者心功能改善,对利尿剂的反应增强,体重下降7kg
Courivaud等^[32]	126(PD)	1年生存率为58%	住院时间从3.3d/(人·月)降为0.3d/(人·月)	左室射血分数增加
Bertoli等^[33]	48(PD)	1年生存率为85%,2年生存率为56%	年入院次数从43次降为11次	PD之前1年需要入院进行体外超滤治疗至少3次,PD之后无

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