臨牀透析 Vol.15 No.4(3)


特集名 小児期の腎不全対策
題名 透析療法 -- 透析技術,食事
発刊年月 1999年 04月
著者 荒木 義則 東京都立清瀬小児病院腎内科
著者 本田 雅敬 東京都立清瀬小児病院腎内科
【 要旨 】 小児の透析,とくに腹膜透析について概説した.透析処方,腹膜カテーテルと出口部感染,感染性腹膜炎,高血圧,残腎機能,除水不良と腹膜平衡試験,硬化性腹膜炎,食事,運動,コンプライアンスの各トピックスについて,重要と思われるポイントを記した.小児の慢性透析には,血液透析よりも腹膜透析のほうが適している.しかしその長期継続に関しては,身体発育,精神的社会的発達の遅延のほか,種々の合併症が問題となる.なかでも硬化性腹膜炎は致命的であり,腹膜透析長期継続例では腹膜生検の必要がある.小児に対する透析治療は腎移植に向け十分な体調を整える準備段階であると考える.
Theme Strategy for the Treatment of Chronic Renal Failure in Children
Title Dialysis treatment in children with ESRD -- The management of dialysis and diet
Author Yoshinori Araki Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
Author Masataka Honda Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
[ Summary ] In this paper, we give an outline of pediatric dialysis, especially peritoneal dialysis. We described the important points of the following topics : dialysis prescription, peritoneal catheters and exit site infections, infectious peritonitis, hypertension, residual renal function, ultrafiltration failure, peritoneal equilibration test, sclerosing peritonitis, diet, exercise, and compliance.
We confirmed that peritoneal dialysis was preferable to hemodialysis for chronic dialysis of children. Long-term peritoneal dialysis, however, would cause physical, psychological, and social problems, and various other complications. Sclerosing peritonitis was a particularly lethal complication. Therefore, peritoneal biopsies should be performed in those patients undergoing long-term peritoneal dialysis. We considered dialytic treatment for children to be a preliminary stage in preparing them for renal transplantation.
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