Dong Jie, Wang Tao, Han Qingfeng, Wang Haiyan
Department of Renal Division, Peking University First Hospital, Beijing 100034 China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2003 Dec 18;35(6):645-8.
To investigate the impact of nutritional status, inflammation and cardiovascular disease on the mortality of 90 patients with continuous ambulatory peritoneal dialysis (CAPD).
A cross-sectional study was performed in 90 clinically stable CAPD patients. Patients' nutritional status (by SGA), chronic inflammation (by CRP), cardiovascular disease (CVD) were evaluated. All patients were followed for 24 months.
Thirty-three of the 90 (36.67%) patients died during the follow-up, five patients transferred to hemodialysis and 3 patients received transplantation. The causes of death were CVD in 12, infection in 13 and other causes in 7. Seventeen patients who died were malnourished. Malnourished patients had significantly higher mortality than well nourished patients (P<0.05). Patients with high serum CRP had higher mortality (P<0.01). CVD patients had also significantly higher mortality (P<0.01). The patients with malnutrition-inflammation-CVD (MIA) syndrome had significantly lower survival rate as compared with those with one or two components of MIA (P<0.01).
During 2-year follow up, 45 percent of 90 CAPD patients left the program. The most common causes of death were CVD and infection. Half of the patients who died were malnourished. Inflammation, malnutrition and CVD may have aggravated each other, and contributed to the poor outcome of this patient population.
探讨营养状况、炎症和心血管疾病对90例持续性非卧床腹膜透析(CAPD)患者死亡率的影响。
对90例临床稳定的CAPD患者进行横断面研究。评估患者的营养状况(通过主观全面评定法)、慢性炎症(通过C反应蛋白)和心血管疾病(CVD)。对所有患者进行24个月的随访。
90例患者中有33例(36.67%)在随访期间死亡,5例患者转为血液透析,3例患者接受了移植。死亡原因中,心血管疾病12例,感染13例,其他原因7例。死亡的17例患者存在营养不良。营养不良患者的死亡率显著高于营养良好的患者(P<0.05)。血清C反应蛋白水平高的患者死亡率更高(P<0.01)。心血管疾病患者的死亡率也显著更高(P<0.01)。与具有营养不良-炎症-心血管疾病(MIA)综合征一个或两个组成部分的患者相比,患有MIA综合征的患者生存率显著更低(P<0.01)。
在2年的随访期间,90例CAPD患者中有45%退出该项目。最常见的死亡原因是心血管疾病和感染。死亡患者中有一半存在营养不良。炎症、营养不良和心血管疾病可能相互加重,导致了该患者群体的不良预后。