血脂与透析患者残余肾功能的关系

The Association between Blood Lipids and Residual Renal Function in Dialysis Patients

摘要: 目的：探讨血脂与透析患者残余肾功能的关系。方法：回顾性分析我院2018年9月~2020年9月收治的200例ESRD病人的临床病历资料，根据透析方式的不同分为血液透析组(100例)和腹膜透析组(100例)，观察透析患者中血脂和残余肾功能的变化以及透析患者治疗24个月内血脂变化。结果：腹透患者总胆固醇和低密度脂蛋白较血透患者显著升高(P < 0.01)。透析治疗初期残余肾功能无明显变化(P > 0.05)。血透患者与腹透患者第12月时RRF较同组透析初月时下降(P < 0.05)。血透患者与腹透患者第12月时总胆固醇和低密度脂蛋白较透析初月时比较显著下降(P < 0.01)。血透患者RRF下降速率与TC (r = 0.503, P < 0.05)、LDL ( r = 0.0.669, P < 0.05)均呈正相关，腹透患者RRF下降速率与TC (r = 0.894, P < 0.05)、LDL (r = 0.860, P < 0.05)均呈正相关。结论：① 腹透患者和血透患者的RRF随着透析时间的延长而降低，血透患者的残余肾功能下降速率大于腹透患者的残余肾功能下降速率。② 透析患者残余肾功能下降速率与TC、LDL水平呈正相关，高血脂对RRF降低有影响。③ ESRD患者随着透析治疗时间的延长出现血脂异常。

Abstract: Objective: To explore the correlation between blood lipid levels and residual renal function in patients undergoing hemodialysis. Methods: The clinical data of 200 ESRD patients admitted to our hospital from September 2018 to September 2020 were retrospectively analyzed. According to the different dialysis methods, the patients were divided into hemodialysis group (100 cases) and peritoneal dialysis group (100 cases). The changes of blood lipid and residual renal function in dialysis patients and the changes of blood lipid in dialysis patients within 24 months of treatment were observed. Results: Total cholesterol and low density lipoprotein in PD patients were significantly higher than those in MHD patients (P < 0.001). There was no significant change in residual renal function at the beginning of dialysis treatment (p > 0.05). The RRF of hemodialysis and peritoneal dialysis patients in the 12th month was lower than that in the first month of dialysis in the same group (P < 0.05). The levels of total cholesterol and low density lipoprotein in hemodialysis patients and peritoneal dialysis patients at the 12th month were significantly lower than those at the beginning of dialysis (P < 0.01). The decline rate of RRF in hemodialysis patients was positively correlated with TC (r = 0.503, P < 0.05) and LDL (r = 0.0.669, P < 0.05), and the decline rate of RRF in peritoneal dialysis patients was positively correlated with TC (r = 0.894, P < 0.05) and LDL (r = 0.860, P < 0.05). Conclusion: ① The RRF of PD and HD patients decreased with the prolongation of dialysis time, and the rate of decline of residual renal function in HD patients was greater than that in PD patients. ② The decline rate of residual renal function in dialysis patients is positively correlated with TC and LDL levels, and hyperlipidemia has an impact on RRF reduction. ③ ESRD patients have dyslipidemia with the extension of dialysis treatment time.