Caron-Lienert Rafaela Siviero, Poli-de-Figueiredo Carlos Eduardo, Figueiredo Ana Elizabeth Prado Lima, da Costa Bartira Ercília Pinheiro, Crepaldi Carlo, Pizzato Alessandra Campani, Ferrari Fiorenza, Giuliani Anna, Ronco Claudio
Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil
International Renal Research Institute of Vicenza, Italy.
Perit Dial Int. 2017 Jul-Aug;37(4):458-463. doi: 10.3747/pdi.2016.00265. Epub 2017 Apr 13.
The characteristics of peritoneal membrane transport differ among patients, affecting the prescription of peritoneal dialysis (PD) modality and glucose exposure in order to achieve an effective dialysis. This study aims to verify the influence of glucose exposure load and peritoneal membrane transport on body composition and nutritional status changes after the first year of PD.
We examined a cohort of 85 incident PD patients during the first year of treatment. We established a cut-off of 5% to define changes in dry weight (DW), lean tissue mass (LTM), and fat mass (FM).
In total, 50.6% of the patients presented DW gain, 41.2% showed LTM loss, and 65.9% presented FM gain. Over the time (T0 - T12), we found significant differences in DW, body mass index (BMI), adipose tissue mass (ATM), FM and fat tissue index (FTI). Patients with lower dialysate-to-plasma creatinine ratio showed DW and FM gain. We observed a higher percentage of nonfast transporters in DW gain when comparing with DW no gain. As for glucose exposure load, no body composition changes were seen.
Most patients presented DW gain, FM gain, and LTM loss. The characteristics of peritoneal membrane transport affected DW during the first year, changes being greater in nonfast than in fast transporters.
腹膜转运特征在患者之间存在差异，这会影响腹膜透析（PD）方式的处方以及葡萄糖暴露情况，以实现有效的透析。本研究旨在验证葡萄糖暴露负荷和腹膜转运对PD治疗第一年之后身体成分和营养状况变化的影响。
我们在治疗的第一年对85例新开始PD治疗的患者进行了研究。我们设定了5%的临界值来定义干体重（DW）、瘦组织质量（LTM）和脂肪质量（FM）的变化。
总体而言，50.6%的患者出现DW增加，41.2%的患者出现LTM减少，65.9%的患者出现FM增加。在整个时间段（T0 - T12）内，我们发现DW、体重指数（BMI）、脂肪组织质量（ATM）、FM和脂肪组织指数（FTI）存在显著差异。透析液与血浆肌酐比值较低的患者出现DW和FM增加。与未出现DW增加的患者相比，我们观察到在出现DW增加的患者中，非快速转运者的比例更高。至于葡萄糖暴露负荷，未观察到身体成分变化。
大多数患者出现DW增加、FM增加和LTM减少。腹膜转运特征在第一年影响DW，非快速转运者的变化大于快速转运者。
