Flanigan M J, Rocco M V, Frankenfield D, Bailie G, Frederick P, Prowant B, Taylor L
Quality Measurement and Health Assessment Group, Wake Forest University School of Medicine, Iowa City, IA, USA.
Am J Kidney Dis. 1999 Jun;33(6):e3. doi: 10.1016/S0272-6386(99)70170-8.
The 1997 Peritoneal Dialysis-Core Indicators Study: Dialysis Adequacy and Nutritional Indicators Report documents the current status of peritoneal dialysis within the United States. A national random sample of adult peritoneal dialysis (PD) patients participating in the United States End Stage Renal Disease (ESRD) program was surveyed. PD subjects were large, with a mean body weight of 76 +/- 18.9 kg (mean +/- 1 SD) and a body mass index (BMI) of 27 +/- 6.4. The dialysis prescriptions documented achieved a mean weekly Kt/Vurea (wKt/V) and weekly creatinine clearance (wCrCl) of 2. 45 +/- 2.29 and 65.5 +/- 35.2 L/wk/1.73m2, respectively. The serum albumin of these patients was 3.5 +/- 0.48 g/dL, their normalized protein equivalent of nitrogen appearance (nPNA) 1.0 +/- 0.63 g/kg/d, and their normalized creatinine appearance rate (nCAR) 14 +/- 6.0 mg/kg/d. Serum albumin correlated meagerly but in a positive fashion with BMI, nPNA, and nCAR, and negatively with wCrCl. Among adult US PD patients, serum albumin values appear to correlate poorly with alternative measures of nutritional status and are inversely related to the intensity of renal replacement therapy. The presumptive dietary protein intake (nPNA) and creatinine appearance rate (nCAR) derived for PD patients do correlate in a positive fashion with dialysis delivery, at least up to a wCrCl of 60 to 80 L/wk/1.73 m2 and wKt/V = 2.1, but their values suggest that 30% to 50% of PD patients have marginal nutritional status.
1997年腹膜透析核心指标研究：透析充分性与营养指标报告记录了美国腹膜透析的现状。对参与美国终末期肾病（ESRD）项目的成年腹膜透析（PD）患者进行了全国随机抽样调查。PD受试者体型较大，平均体重为76±18.9千克（均值±1标准差），体重指数（BMI）为27±6.4。记录的透析处方实现的平均每周尿素清除率（wKt/V）和每周肌酐清除率（wCrCl）分别为2.45±2.29和65.5±35.2升/周/1.73平方米。这些患者的血清白蛋白为3.5±0.48克/分升，其标准化蛋白氮出现率（nPNA）为1.0±0.63克/千克/天，标准化肌酐出现率（nCAR）为14±6.0毫克/千克/天。血清白蛋白与BMI、nPNA和nCAR呈微弱但正相关，与wCrCl呈负相关。在美国成年PD患者中，血清白蛋白值与营养状况的替代指标相关性似乎较差，且与肾脏替代治疗强度呈负相关。为PD患者推算的假定膳食蛋白质摄入量（nPNA）和肌酐出现率（nCAR）与透析剂量呈正相关，至少在wCrCl达到60至80升/周/1.73平方米且wKt/V = 2.1之前是这样，但它们的值表明30%至50%的PD患者营养状况处于边缘状态。
