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KMID : 0882419930440030390
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Korean Journal of Medicine
1993 Volume.44 No. 3 p.390 ~ p.399
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Comparative Study of Hemodynamics and Rehabilitation According to Three Modalities of Treatment, HD, CAPD and KTP, in ESRD Patients
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박선자
고용호/김민철/이병준/김영곤/박상은/이재우/이시래
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Abstract
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ackground and Method : Hypertension and atherosclerosis are known to be most common
complications and causes of death in end stage renal diseases. We, therefore, evaluated in
pressent study hemodynamics, requirement of antihypertensive drugs, and physicsal ability
(assessed by Karnofsky score) in 380 patients with end stage renal diseases treated by
hemodialysis (HD,65 patients), continous ambulatory peritoneral dialysis(CAPD,131 patients) or
renal transplantation (KTP,184 patients) in Kosin Medical Center Hospital during the period of
1983 through 1991.
Results : Systolic and diastolic blood pressures decreased significantly from 152.50±20.62
(mean S.D.)/96.88±16.39 mmHg before therapy to 146.46±17.32/96.2±10.62 at the end of
3month therapy in HD group, from 158.49±24.08/96.49±17.86 to 144.11±20.27/90.27±12.27 in
CAPD group, and from 154.28±21.60/95.69±14.50 to 133.33±14.57/84.07±11.93 in KTP group,
the change being most extensive in KTP group and least in HD group. The number of
antihypertensive drugs required was reduced after therapy in the order of KTP, CAPD and
HD groups. Cardiothoracic ratio was decreased after therapy in 77.4% of KTP, 67.4% of
CAPD and 42.2% of HD patients. In echocardiogram. LVIDd, LVIDs and SV appeared to be
significantly decreased in KTP and CAPD groups with a greater extent in the former, but not
in HD group. Electrocardiogram was improved in 37.6% of KTP, 20.5% of CAPD and 6.7%
of HD patients. Karnofsky scores for the first grade rehabilitation were observed in 85% of
KTP, 61.5% of CAPD and 64.3% of HD patients.
Conclustions : These results indicate that, in terms of hemodynamics and physical ability,
KTP is a better way of treatment of end stage renal diseases as compared with CAPD and
HD, and that among dialysis treatments, CAPD is superior to HD.
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KEYWORD
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