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首页> 外文期刊>CEN Case Reports >Successful treatment of icodextrin-single peritoneal dialysis for refractory nephrotic syndrome induced by idiopathic membranous nephropathy
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Successful treatment of icodextrin-single peritoneal dialysis for refractory nephrotic syndrome induced by idiopathic membranous nephropathy

机译：艾考糊精单次腹膜透析治疗特发性膜性肾病致难治性肾病综合征的成功治疗

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The patient was a 76-year-old male who developed nephrotic syndrome. Idiopathic membranous nephropathy was diagnosed by renal biopsy and clinical findings. The patient had been refractory to predonisolone and cyclosporine A therapies, and overhydration recurred repeatedly during the clinical course. One year after an initial hospitalization, he had to be hospitalized a second time because of overhydration. During the hospitalization, he underwent fluid removal by the extracorporeal ultrafiltration method (ECUM), as his response to diuretics was too weak to permit the control of cardiac insufficiency. The ECUM alleviated his overhydration, but no remission of nephrotic syndrome was achieved. The patient was then discharged temporarily, but overhydration developed again 2 months later. Peritoneal dialysis (PD) using an overnight dwell of a single dose of icodextrin was initiated to obtain stable fluid removal. This promptly alleviated the refractory subcutaneous edema, and type I incomplete remission of nephrotic syndrome was achieved about 2 weeks after the start of PD. The patient could be withdrawn from the PD therapy 4 months later. Subsequently, the urinary volume was maintained and the serum creatinine level was stabilized at about 2 mg/dl. In our patient, the protein leakage into the drainage was small enough to permit remission of the nephrotic syndrome with stable fluid removal. On this basis, we believe that PD using icodextrin is considered as one of the options for the treatment of refractory nephrotic syndrome with poor water control.
机译：该患者是一名76岁的男性，患有肾病综合征。肾活检和临床发现可诊断出特发性膜性肾病。该患者对泼尼松龙和环孢素A治疗无效，并且在临床过程中反复出现过多的水肿。初次住院一年后，由于水分过多，他不得不第二次住院。住院期间，由于对利尿剂的反应太弱，无法控制心脏功能不全，因此他通过体外超滤法（ECUM）进行了输液。 ECUM缓解了他的过度水肿，但没有缓解肾病综合征。然后患者暂时出院，但两个月后又出现了水肿。开始使用单剂量艾考糊精的过夜停留进行腹膜透析（PD），以获得稳定的体液去除。这立即减轻了难治性皮下水肿，并且在PD开始后约2周实现了I型肾病综合征的不完全缓解。患者可以在4个月后退出PD治疗。随后，维持尿量并将血清肌酐水平稳定在约2mg / dl。在我们的患者中，蛋白质流到引流管的泄漏很小，足以使肾病综合征得以缓解，并有稳定的液体排出。在此基础上，我们认为使用艾考糊精的腹膜透析被认为是控制水质不佳的难治性肾病综合征的一种选择。

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