Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
J Ren Nutr. 2013 Nov;23(6):438-44. doi: 10.1053/j.jrn.2013.04.005. Epub 2013 Jun 22.
The aim of this study is to evaluate changes in body composition in accordance with residual renal function (RRF).
Two hundred forty-four patients with more than 1 year of follow-up were enrolled. The mean value of RRF at peritoneal dialysis (PD) initiation and 1 year after PD initiation was used as an indicator of the time-averaged RRF (TA-RRF). The patients were divided into 3 groups with respect to the tertile of the TA-RRF level: low tertile (n = 81), middle tertile (n = 82), and high tertile (n = 81). Body composition measurement was determined from dual-energy X-ray absorptiometry and bioimpedance analysis. This analysis was performed at PD initiation and 1 year after PD initiation.
Multivariate analysis showed that the high TA-RRF tertile was associated with an increase in lean mass index. Fat mass index in all tertiles and bone mineral content index in the middle and high TA-RRF tertiles were increased, but no significant difference were observed in these changes among the 3 tertiles. The edema index decreased over the 1-year PD period. The high TA-RRF tertile was associated with a lower edema index. Although there was no statistical significance, the increase in fat mass/lean mass ratio (FM/LM) attenuated as the grade of TA-RRF tertile increased. The increase in fat mass index was similar to the trend in FM/LM.
TA-RRF was associated with an increase in total lean mass and a decrease in edema index.
本研究旨在评估根据残余肾功能 (RRF) 变化的身体成分变化。
纳入 244 例随访时间超过 1 年的患者。将 PD 起始时和 PD 起始后 1 年的 RRF 平均值作为时间平均 RRF (TA-RRF) 的指标。根据 TA-RRF 水平的三分位将患者分为 3 组:低三分位组(n = 81)、中三分位组(n = 82)和高三分位组(n = 81)。采用双能 X 射线吸收法和生物电阻抗分析法测定身体成分。该分析在 PD 起始时和 PD 起始后 1 年进行。
多变量分析显示,高 TA-RRF 三分位与瘦体重指数增加相关。所有三分位的脂肪质量指数和中、高三分位的骨矿物质含量指数均增加,但这三个三分位之间的这些变化没有显著差异。在 PD 期间,水肿指数在 1 年内下降。高 TA-RRF 三分位与较低的水肿指数相关。虽然没有统计学意义,但随着 TA-RRF 三分位等级的增加,脂肪质量/瘦体重比 (FM/LM) 的增加趋势减弱。脂肪质量指数的增加与 FM/LM 的趋势相似。
TA-RRF 与总瘦体重增加和水肿指数降低有关。