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Refractory focal segmental glomerular sclerosis (focal segmental glomerular sclerosis, FSGS) is not only clinical treatment is difficult, and in the course of treatment can easily complicated by a variety of complications, including acute injury (acute kidney injury, AKI) See. Continuous renal replacement therapy (continuous renal replacement therap, CRRT) is the main treatment, but because of its expense, take up a lot of medical resources, not home treatment limitations, not clinical long-term use, on the part of short-term renal function can not be restored negative patients. Peritoneal dialysis (peritoneal dialysis, PD) is a means of renal replacement therapy, PD can achieve the CRRT similar effect? ??Therefore, this article is designed to observe the PD security AKI patients with FSGS, analysis its possible efficacy. Provide the basis for clinical treatment. This article into the group of 19 patients, improved peritoneal dialysis tube into the methods, selection of the Swan-Neck straight, after that take a day ambulatory peritoneal dialysis (daily DIALYSIS ambulatory peritoneal dialysis DAPD) mode, the daily exchange volume of 1L 8L, patients are generally indicators (height, weight, blood pressure, urine output, etc.) were followed up for more than 3 months, respectively, at baseline, follow-up 4 weeks, 8 weeks, 12 weeks and 16 weeks, records, blood, blood biochemistry (including liver and kidney function, electrolytes and glucose) dialysis-related parameters (dose, urea clearance index, creatinine clearance, glomerular filtration rate), thoracic and abdominal plain film. The results showed that: the total effective rate was 73.7% (14/19). Of these, 10 patients (52.6%) achieved complete remission, four cases of partial remission, 5 patients without remission. More than 70% of patients with PD treatment satisfactory control of edema, hypertension, serum creatinine (SCr) decreased in the last follow-up to the underlying value of 65.6% (P GT; 0.05), BUN decreased to baseline values ??47.9% (P lt; 0.01 ), albumin, prealbumin pick-up (P lt; 0.01), urine output increased (P lt; 0.01), urinary protein, NAG decreased (P lt; 0.01), RBP also decreased slightly (P gt; 0.05). Further dynamic observed swelling of more than the Pd 4 weeks subsided, urine output, Scr, BUN more than PD 12 weeks of recovery. PD course of 2-10 months, the average PD (5.0 ± 2.9) months, renal function returned to normal for PD 1 to 6 months, 80% of patients after PD April reached complete remission. PD-related complications in 8 patients (42.0%), of which 5 cases of peritonitis, peritonitis (3.13 1.44) month. 4 cases of cultured Escherichia coli, 1 case of Staphylococcus aureus, the catheter exit of infection in 1 case, 1 case of poor drainage of the dialysate, 1 case of dialysate pleural leakage. No drift tube peritubular exudate, abdominal organ injury. 1 patient died of PD-related complications. 24h dialysate total protein content as 0.73 g / L of this study show that: the short-term average dialysis (5.0 ± 2.9) months] PD can be used as an effective adjunct treatment of FSGS accompanied AKI, particularly applicable to the clinical manifestations of the degree of swelling, massive ascites AKI patients, a significant effect (overall response rate of 73.7%), peritoneal dialysis-related complications were cured.
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