• 作者：Belkacem Issad ; Pierre-Yves Dur ; Pascale Siohan ; 脡ric Goffin ; Jo毛lle Cridlig ; Guillaume Jean ; Jean-Philippe Ryckelynck ; Commission de dialyse de la Soci茅t茅 de n茅phrologie
• 关键词：Dialyse pé ; ritoné ; ale ; Adé ; quation ; KT/V uré ; e ; Clairance des soluté ; s ; Balance hydrosodé ; e ; Malnutrition ; Straté ; gies d&rsquo ; é ; pargne en glucose
• 刊名：Néphrologie Thérapeutique
• 出版年：November, 2013
• 年：2013
• 卷：9
• 期：6
• 页码：416-425
• 全文大小：416 K

The optimal method to assess the adequacy of peritoneal dialysis therapies is controversial. Today, the adequacy must not be considered as a number or a concept assessed only by two parameters (total KT/V urea and total solute clearance) but defined by many more items. In the absence of data, based on theoretical considerations, the reanalysis of the CANUSA study showed that renal kidney function, rather than peritoneal clearance, was associated with improved survival. Residual renal function is considered as a major predictor factor of cardiovascular mortality. Results of this reanalysis were supported by the adequacy data in ADEMEX, EAPOS and ANZDATA studies. Therefore, clinical assessment plays a major role in PD adequacy. The management of fluid balance, the regular monitoring of malnutrition, the control of mineral metabolism and particularly the glucose load, considered as the 鈥渃orner-stone鈥?of the system, are the main points to be considered in the adequacy of PD patients. The essential goal is to minimize glucose load by glucose-sparing strategies in order to reduce the neoangiogenesis of the peritoneal membrane.