개에서 복막투석 적용: 20 증례 (2006-2008)

Peritoneal Dialysis in Dogs: 20 cases (2006-2008)

  • 남소정 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 최란 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 오원석 (대구 황금동물병원) ;
  • 현창백 (강원대학교 수의(학부)대학 소동물 내과교실)
  • Nam, So-Jeong (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Choi, Ran (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Oh, Won-Seok (Hwanggeum Geriatric Animal Hospital) ;
  • Hyun, Chang-Baig (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University)
  • 발행 : 2009.02.27

초록

복막투석은 정상적인 생리적 상태의 장애를 야기하는 체내의 독성물질을 치료적으로 제거하는 임상적 방법이다. 본 연구에서는 신부전으로 내원한 환자에게 복막투석을 적용한 20증례의 임상적 결과와 합병증을 후향적으로 평가하였다. 복막투석을 실시하는 동안 적혈구수, 혈구용적, 신기능과 관련된 혈액 화학적 수치 및 전해질 등의 혈액학적 분석과 합병증, 임상적 결과 등을 기록하였다. 복막투석의 결과로 19마리의 개에서 혈중 요소 질산 농도가 유의하게 감소하였고 (p<0.05), 17마리의 개에서 혈중 크레아티닌의 농도가 유의하게 감소하였다 (p<0.05). 복막투석의 부작용으로는 저알부민혈증(12/20, 60%), 빈혈(10/20, 50%), 투석액의 피하 누출(9/20, 45%), 세균성 복막염 (6/20, 30%), 투석액의 저류 (5/20, 25%)와 사지의 부종(4/20, 20%)이 나타났다. 본 증례고찰을 통하여 복막투석은 신부전(특히 급성기)에 이환된 개에서 질소혈증을 개선하는데 효과적임을 알 수 있었다.

Peritoneal dialysis (PD) is a clinical technique that therapeutically removes toxic solutes from body fluids and normalizes endogenous solutes whose aberrant concentrations disrupt normal physiology. This study retrospectively evaluated clinical outcomes and complications of PD in 20 dogs with renal failure. Blood works (total count of red blood cells (RBC), packed cell volume (PCV), the serum biochemical, and electrolyte values related to renal insufficiency) and complications associated with peritoneal dialysis, and clinical outcomes were recorded before and after PD. Additionally, creatinine reduction ratio (CRR) and urea nitrogen reduction ratio (URR) were calculated for evaluating the efficacy of PD. PD resulted in a significant (p < 0.05) reduction in blood urea nitrogen (BUN) concentration in 19 dogs, while a significant (p < 0.05) reduction in creatinine concentration in 17 dogs. The complications of PD were hypoalbuminemia (12/20, 60%), anemia (10/20, 50%), subcutaneous dialysate leakage (9/20, 45%), bacterial peritonitis (6/20, 30%), dialysate retention (5/20, 25%) and limb edema (4/20, 20%). This study demonstrated that PD was effective in reducing the magnitude of azotemia in dogs with renal failure especially in acute phase, although the complication rate was high but manageable.

키워드

참고문헌

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