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장기 투석치료 환자에서 투석 유형별에 따른 혈증 Mg 과 CO2 의 농도에 관한 연구 |
이상주 , 강신욱 , 함영환 , 정동균 , 이호영 , 한대석 |
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Abstract |
The seurm magnesium concentration is usually ele- vated in patients with end stage renal disease and its toxic effect such as hypotension, nausea, vomiting, CNS depression, cardiac arrest has already been reported. Acidosis is not seldom present in end stage renal disease and it can affect the concentration of electrolytes in serum, and can exacerbate renal osteodystrophy. So maintaining the serum magnesium and CO, level within normal or near normal range can prevent the toxic effect of hypermagnesemia and acidosis usually occuring in end stage renal disease, and one can consider that not only the dialysis technique but also the concentration of the solutes in the dialysate may affect their serum level. To evaluate the effect of concentration of the solutes in the dialysate and difference in each dialysis tech- nique, we reviewed the magnesium and CO concentra- tion in normal (40), patients receiving hemodialysis(HD) (13), and patients receiving continuous ambulatory per- itoneal dialysis (CAPD) (62). The results are followings: 1) The serum magnesium concentration in patients with chronic dialysis was significantly higher than that in control group (2.01±0.25mg/dl) regardless of the dialysis technique, dialysate, and the duration of dialysis (p < 0.05). 2) The serum magnesium concentration of the HD group in postdialysis 1 month, 3 months, 6 months, 12 months, and 24 months were 2.570.28, 2.81±0.18, 2.73± 0.23, 2.73±0.28, and 2.70±0.01, and it was hgher than that of the CAPD group, but there was no statisticdifference between each groups. 3) According to the dialysate, the magnesium concen- tration in the Dianeal group in postdialysis 1 month, 6 months, 12 months, and 24 months were 2.27±0.50, 2. 40±0.52, 2,39±0.48, and 2.44±0.40 respectively, and they were significantly lower than them of the Peritosol group at the same period measuring 2.73+0.50, 2.80±0. 30, 2.81±0.38, and 2.56±.38 respectively (p<0.05). 4) The CO, concentration in serum of the HD group in predialysis, postdialysis 1 month, 3 months, 6 months, 12 months, and 24 months were 13.4±3.6, 16.8±3.3, 18.2±4. 1, 15.8±2.5, 14.4±2.6, and 16.0±1.0 respectively, and they were significantly lower than that of the control group (25.6± 2.8 mM/1)(p < 0.05). 5) The CO, concentration in the Peritosol group in postdialysis 1 month, 6 months, 12 months, and 24 months were 22.8±2.8, 23.0±2.7, 22.6±3.4, and 22.0±3.0 respectively, and they were significantly lower than them of the Dianeal group at the same period measuring 24.6±3.0, 24.9±2.5, 24.8±3.2, and 24.6±2.9 respectively (p < 0.05). Based on these results, it seems that CAPD patients are able to maintain more physiologic serum magne- sium and CO level compared to HD patients and the concentration of the solutes in the dialysate can affect the serum level. |
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