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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: To observe the effect of continuous ambulatory peritoneal dialysis (CAPD) on acquired immunodeficiency syndrome (AIDS) complicated with end-stage renal disease (ESRD). METHODS: One case of a male patient diagnosed with AIDS developed proteinuria and renal insufficiency after one year with chronic hepatitis C, hemophilia A (factor VIII deficiency) and diabetes, and high-potency anti-retroviral therapy (HAART) After ESRD, patients underwent CAPD. The changes of residual renal function, anemia, calcium and phosphorus metabolism, cardiac function and nutritional status were observed before and after CAPRD, and the adequacy of dialysis and complication assessment were evaluated. Results: Hypertension, anemia, azotemia, acidosis and cardiac function were significantly improved after CAPD treatment in patients with stable weight and no edema, Kt / V2.01 / week, nPCR1.133g / (kg.d). Malnutrition - inflammation - cardiovascular disease syndrome and metabolic disorders exist. Conclusion: AIDS complicated with ESRD with CAPD as a renal replacement therapy can achieve satisfactory results.