長期腹膜透析の検討―心疾患を合併した例の透析適応について

抄録

Twenty-one patients of chronic renal failure with congenital and aquired heart diseases have been treated with long-term peritoneal dialysis. Hemodynamical effect of peritoneal and hemodialysis on the patients of chronic renal failure examined by mechanocardiography.
The results of mechanocardiogram recorded during peritoneal dialysis suggest that the dialysis does not introduce hemodynamical load on the heart of the patient. The results of mechanocardiograms from the same patient recorded during peritoneal and hemo-dialysis respectively suggest that hemodynamical load on the heart by peritonea ldialysis is much less than that of hemodialysis in following reasons;
1. Cardiac output increases in both peritoneal and hemo-dialysis, but increment of it is bigger in peritoneal dialysiss than hemodialysis.
2. Ejection time index decreases in hemodialysis.
3. Isometric contraction time decreases in peritoneal dialysis but increases in hemodialysis.
4. Ejection time and pre-ejection period ratio is much decreased in hemodialysis than peritoneal dialysis, and decrease of myocardial contractility might exist during hemodialysis.
Furthermore, since middle molecular weight substances are well dialysed by peritoneal dialysis rather than hemodialysis, peritoneal dialysis might be suitable treatment for uremic patients with heart diseases. Survival rate of the patients treated by long-term peritoneal dialysis is not statistically different from that of the patients treated with hemodialysis aged between 41 to 65 (mean±1 S. D. of age of peritoneal dialysed patients). Tenckhoff chronic catheter was used in all cases and this catheter seems to be the best one for currying the long-term peritoneal dialysis.