Liu Yun, Huang Rong, Guo Qunying, Yang Qiongqiong, Yi Chunyan, Lin Jianxiong, Yu Xueqing, Yang Xiao
Department of Nephrology,The First Affiliated Hospital, Sun Yat-sen University,58th Zhongshan Road II,Guangzhou510080,China.
Br J Nutr. 2015 Aug 14;114(3):398-405. doi: 10.1017/S0007114515001804.
The aim of the present study was to investigate the relationship between baseline peritoneal transport types and nutritional status in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients. In the present single-centre, prospective study, incident CAPD patients were included from 15 April 2010 to 31 December 2011 and were followed up for 12 months. According to the results of baseline peritoneal equilibration test, patients were divided into lower peritoneal transport group (lower transporters) and higher peritoneal transport group (higher transporters). Nutritional status was evaluated by both subjective global assessment (SGA) and protein-energy wasting (PEW) score. The body composition parameters were assessed by body impedance analysis. A total of 283 CAPD patients were included in the study, of which 171 (60.4 %) were males with a mean age of 47.0 (sd 14.9) years. Compared with lower transporters (n 92), higher transporters (n 181) had lower levels of serum albumin (37.1 (sd 4.3) v. 39.6 (sd 4.3) g/l, P< 0.001), serum pre-albumin (356 (sd 99) v. 384 (sd 90) mg/l, P= 0.035), phase angle (6.15 (sd 0.39) v. 6.27 (sd 0.47)°, P< 0.05) and higher rate of malnutrition defined by SGA (52.5 v. 25.0%, P< 0.001) and PEW score (37.0 v. 14.1 %, P< 0.001) at 1-year of follow-up. Baseline higher peritoneal transport, analysed by multivariate binary logistic regressions, was independently associated with malnutrition (SGA mild to moderate and severe malnutrition: OR 3.43, 95% CI 1.69, 6.96, P< 0.01; PEW: OR 2.40, 95% CI 1.08, 5.31, P= 0.03). It was concluded that baseline higher peritoneal transport was independently associated with worse nutritional status of CAPD patients in Southern China.
本研究旨在探讨中国持续性非卧床腹膜透析(CAPD)患者的基线腹膜转运类型与营养状况之间的关系。在本单中心前瞻性研究中,纳入了2010年4月15日至2011年12月31日期间开始进行CAPD治疗的患者,并对其进行了为期12个月的随访。根据基线腹膜平衡试验结果,将患者分为低腹膜转运组(低转运者)和高腹膜转运组(高转运者)。通过主观全面评定法(SGA)和蛋白质 - 能量消耗(PEW)评分评估营养状况。采用人体阻抗分析评估身体成分参数。本研究共纳入283例CAPD患者,其中171例(60.4%)为男性,平均年龄47.0(标准差14.9)岁。与低转运者(n = 92)相比,高转运者(n = 181)在随访1年时血清白蛋白水平较低(37.1(标准差4.3)对39.6(标准差4.3)g/L,P < 0.001)、血清前白蛋白水平较低(356(标准差99)对384(标准差90)mg/L,P = 0.035)、相位角较低(6.15(标准差0.39)对6.27(标准差0.47)°,P < 0.05),且SGA定义的营养不良发生率较高(52.5%对25.0%,P < 0.001)以及PEW评分较高(37.0%对14.1%,P < 0.001)。多因素二元逻辑回归分析显示,基线高腹膜转运与营养不良独立相关(SGA轻度至中度及重度营养不良:比值比3.43,95%置信区间1.69, 6.96,P < 0.01;PEW:比值比2.40,95%置信区间1.08, 5.31,P = 0.03)。研究得出结论,在中国南方,基线高腹膜转运与CAPD患者较差的营养状况独立相关。