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간경변증이 동반된 말기신부전증환자에서의 신대체 요법
Comparison between Hemodialysis and Peritoneal Dialysis in Patients with End-stage Renal Disease and Liver Cirrhosis

대한신장학회지 2007년 26권 6호 p.705 ~ p.715

김민수(Kim Min-Su) - 연세대학교 의과대학 내과학교실
양재원(Yang Jae-Won) - 연세대학교 의과대학 내과학교실
한승태(Han Seung-Tae) - 연세대학교 의과대학 내과학교실
김재석(Kim Jae-Seok) - 연세대학교 의과대학 내과학교실
김비로(Kim Bi-Ro) - 연세대학교 원주의과대학 내과학교실
한병근(Han Byoung-Geun) - 연세대학교 의과대학 내과학교실
최승옥(Choi Seung-Ok) - 연세대학교 의과대학 내과학교실

Abstract

Purpose: During hemodialysis (HD) in patients with end-stage renal disease (ESRD) and preexisting liver cirrhosis (LC), there is a risk of inadequate ultrafiltration due to either intradialytic hypotension or a coagulopathy causing complications from alteration of clotting factors and platelets. Peritoneal dialysis has several benefits over HD for cirrhotic patients including proper hemodynamic stability, avoidance of anticoagulants and direct removal of ascitic fluid. We compared the factors associated with the survival rates in patients with ESRD and LC undergoing dialysis.

Methods: We analyzed 41 ESRD patients with LC (HD 23 patients, PD 18 patients). Their characteristics and laboratory findings at the beginning of dialysis, and survival rates were retrospectively analyzed.

Results: There was no significant difference in survival time with the treatment modality. The patients with severe ascites at the beginning of dialysis, low albumin (serum albumin <3.0 g/dL), high modified Child-Pugh score (MCP score ≥7) and low hemoglobin (Hb) level (Hb <10 g/dL) had poor survival. The multivariate analysis showed that age, the amount of ascites, the initial Hb level and the modified Child-Pugh score were risk factors for death.

Conclusion: PD was an effective renal replacement therapy for patients with ESRD and LC. Patients with a modified Child-Pugh classification of A and B were not significantly different with regard to survival rates. Therefore, PD may be a safe and effective option for patients with ESRD and LC.

키워드

Liver cirrhosis, End stage renal disease, Peritoneal dialysis

KMID : 0359920070260060705

원문 및 링크아웃 정보

등재저널 정보

주제코드

주제명(Target field)

연구대상(Population)

연구참여(Sample size)

대상성별(Gender)

질병특성(Condition Category)

연구환경(Setting)

연구설계(Study Design)

연구기간(Period)

중재방법(Intervention Type)

중재명칭(Intervention Name)

키워드(Keyword)

유효성결과(Recomendation)

PD was an effective renal replacement therapy for patients with ESRD and LC.

연구비지원(Fund Source)

근거수준평가(Evidence Hierarchy)

출판년도(Year)

참여저자수(Authors)

대표저자

DOI

KCD코드

ICD 03

건강보험코드

간경변증이 동반된 말기신부전증환자에서의 신대체 요법 Comparison between Hemodialysis and Peritoneal Dialysis in Patients with End-stage Renal Disease and Liver Cirrhosis

Abstract

키워드

간경변증이 동반된 말기신부전증환자에서의 신대체 요법
Comparison between Hemodialysis and Peritoneal Dialysis in Patients with End-stage Renal Disease and Liver Cirrhosis