В любом случае, вам, пациентам, стоит сообща подарить своему доктору "Руководство по диализу" Джона Даугирдаса, русский перевод которого мы выполнили несколько лет назад. 700 страниц текста. Очень сильно помогает. Книгу можете заказать у меня. Вышлю почтой.

Правильно. Как-то у меня резко уменьшилось выделение жидкости. Выделяла допустим 1л, а стала выделять 100гр. С этим вопросом я и обратилась к врачу, т.к. испугалась. На, что и получила ответ, что ты не бойся, это даже очень хорошо. У диализных больных не должно быть мочи соовсем ну и т.д. Через несколько дней у меня опять все восстановилось, и я успокоилась. А что это было я незнаю. Почему вдруг резко на несколько дней снизилось выделение мочи, хотя количество потребляемой жидкости было на прежнем уровне.

Да, я очень хочу заказать у Вас эту книгу, вначале прочитать самой, а потом подарить врачу. Что от меня требуется?

Am J Kidney Dis. 2001 Jul;38(1):85-90.
Residual renal function and mortality risk in hemodialysis patients.
Shemin D, Bostom AG, Laliberty P, Dworkin LD.

Renal Division, Rhode Island Hospital, Providence, RI 02903, USA. dshemin@lifespan.org

Residual renal function, defined as the urinary clearance of urea and creatinine, is minimal in many patients treated with hemodialysis (HD) and tends to be ignored in most outcome studies involving HD patients. Recent studies showed that residual renal function, even at a low level, is influential in preventing mortality in the minority of patients with end-stage renal disease treated with peritoneal dialysis. This issue generally has not been examined in patients treated with HD. This prospective observational study of all 114 patients at a single community-based freestanding HD center is designed to examine the impact of residual renal function (defined as renal urea clearance and renal creatinine clearance derived from 24-hour urinary volumes) on mortality over a 2-year period. During that period, 50 deaths occurred in 114 patients. The presence of residual renal function was protective against mortality (odds ratio for death, 0.44; 95% confidence interval, 0.24 to 0.81; P = 0.008), even after adjustment for duration of dialysis treatment, age, smoking, presence of diabetes, presence of cardiovascular disease, serum albumin level, and urea reduction rate. In conclusion, the presence of residual renal function, even at a low level, is associated with a lower mortality risk in HD patients.

На ПД - вообще давно известно, что остаточная функция улучшает выживание.

J Am Soc Nephrol 12:2450-2457, 2001
© 2001 American Society of Nephrology
Independent Effects of Residual Renal Function and Dialysis Adequacy on Actual Dietary Protein, Calorie, and Other Nutrient Intake in Patients on Continuous Ambulatory Peritoneal Dialysis
ANGELA YEE-MOON WANG, MANDY MAN-MEI SEA, RICKY IP, MAN-CHING LAW, KAI-MING CHOW, SIU-FAI LUI, PHILIP KAM-TAO LI and JEAN WOO

Department of Medicine and Therapeutics, Center for Nutritional Studies, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.

Correspondence to Dr. Angela Y.M. Wang, Senior Registrar, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T., Hong Kong. Phone: 852-2632-3487; Fax: 852-26375396; E-mail: awang@cuhk.edu.hk

Abstract. Previous studies have suggested that the cross-sectional relationship observed between total solute clearance (Kt/V) and dietary protein intake (DPI) in patients undergoing dialysis is possibly mathematical in origin. A cross-sectional study on 242 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) was performed to determine the differential effects of dialysis adequacy and residual renal function (RRF) on actual dietary intake. All patients underwent a 7-d food frequency questionnaire to quantify daily dietary protein, calorie (DCI), and other nutrient intake, subjective global assessment (SGA), and collection of 24-h dialysate and urine for total (PD and renal) Kt/V and RRF. Patients were categorized into three groups: I (n = 94), total Kt/V >=1.7 and GFR >0.5 ml/min per 1.73 m2; II (n = 58), total Kt/V >=1.7 but GFR <0.5 ml/min per 1.73 m2; and III (n = 90), total Kt/V <1.7. Sixty-nine percent versus 62% versus 42% of group I versus II versus III patients were well nourished according to SGA (P = 0.004). DPI (1.23 [0.47] versus 1.12 [0.49] versus 0.99 [0.40] g/kg per d; P = 0.002) and DCI (27.3 [8.9] versus 23.8 [8.6] versus 23.0 [8.2] kcal/kg per d; P = 0.002) showed significant decline across the three groups. Intake of other nutrients, including carbohydrate, fat, fatty acids, and cholesterol was higher for group I compared with groups II and III. Adjusting for age, gender, weight, and diabetes, every 1 ml/min per 1.73 m2 increase in GFR was associated with a 0.838-fold increase in DCI (95% confidence interval to interval, 0.279 to 1.397; P = 0.003) and a 0.041-fold increase in DPI (95% confidence interval, 0.009 to 0.072; P = 0.012), whereas every 0.25-unit increase in total (PD and renal) Kt/V was associated with a 0.570-fold increase in DCI (95% confidence interval, 0.049 to 1.092; P = 0.032) and a 0.052-fold increase in DPI (95% confidence interval, 0.023 to 0.081; P = 0.001). Greater small-solute clearances are associated with better dietary intake and better nutrition. The study confirmed significant and independent effect of RRF, but not PD solute clearance, on actual DPI, DCI, and other nutrient intake in patients on CAPD.