不同透析方式对糖尿病肾病患者脂代谢及肾性贫血相关指标的影响

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Effectsof Different Dialysis Methodson Lipid MetabolismandRenal Anemia Related Indexes in Diabetic Kidney Disease Patients/YUGuo'an，ZHU Qingxiu，JIANG Yao，WANGShuifa，HEGuizhen.// Medical Innovation of China，2025，22（30）： 005-009

[Abstract]Objective：To compare the effects of maintenance hemodialysis （MHD） and continuous ambulatory peritonealdialysis（CAPD）onlipidmetabolismandrenalanemiarelatedindexesof patientswithdiabetic kidney disease （DKD），and to provide evidence for the selectionof individualized dialysis regimens.Method：A prospective randomized controled design was adopted to include DKD patients newly diagnosed with end-stage renal disease （ESRD） requiring initiation of maintenancedialysis in theDepartment of Nephrology，the Third People's Hospital of Jingdezhen from January 202O to January 2O24.They were randomly divided into MHD group （ n =40）and CAPD group（ n =40）by random number table method，The MHD group was treated with MHD，and the CAPD group was treated with CAPD.All patientsreceived regular dialysis treatment for6 months.The differences of lipid metabolism indexes （TC，TG，LDL-C，HDL-C），renal anemia indexes [Hb，serum feritin （SF），trasferrin saturation （TSAT）]，renal function indexes （Scr，BUN） and nutrition-related indexes （ALB）beforedialysisand 6 months after dialysis were compared between the two groups.Result： After 6 months of dialysis，the levels of serum TG，TC and LDL-C inthe CAPD group were higher than those in the MHD group，and the levelof HDL-C was lower than that in the MHD group （ P <0.05）; the levels of serum Hb，SF and TSAT in the MHD group were higher than those inthe CAPD group（ P <0.05）;the levels of Scr，BUN and ALB inboth groupsdecreased significantly compared with those before dialysis （ P <0.05），but there were no statistical differences between the groups （ P >0.05）. Conclusion： CAPD maylead to more significant lipid metabolism disorders，and MHD may have more advantages in improvig renalanemia.Whenselecting dialysis methods inclinical practice，it isnecessaryto weigh theirdierent effects on metabolism and anemia and make individual decisions.

[Keywords]Diabetic kidney diseaseMaintenance hemodialysisPeritoneal dialysisLipid metabolism ienal anemia

First-author'saddress：Department of Nephrology，the Third People's Hospital of Jingdezhen ingdezhen333000， China

doi：10.3969/j.issn.1674-4985.2025.30.002

糖尿病肾病（diabetickidneydisease，DKD）为终末期肾脏病（end-stagerenal disease，ESRD）的首要病因，疾病进展至透析依赖阶段时维持性血液透析（maintenancehemodialysis，MHD）与持续不卧床腹膜透析（continuousambulatoryperitonealdialysis，CAPD）为此类疾病患者维系生命的主要治疗手段[-2]。（剩余6467字）