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贫血与克罗地亚腹膜透析患者的营养不良和炎症相关:一项全国多中心研究。

Anemia Is Correlated with Malnutrition and Inflammation in Croatian Peritoneal Dialysis Patients: A Multicenter Nationwide Study.

作者信息

Radić Josipa, Bašić-Jukić Nikolina, Vujičić Božidar, Klarić Dragan, Radulović Goran, Jakić Marko, Jurić Klara, Altabas Karmela, Grđan Željka, Kovačević-Vojtušek Ivana, Martinović ValentináCorić, Janković Nikola, Gulin Marijana, Ljutić Dragan, Rački Sanjin

机构信息

Department of Nephrology and Dialysis, University Hospital Centre Split, Split, Croatia

Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.

出版信息

Perit Dial Int. 2017 Jul-Aug;37(4):472-475. doi: 10.3747/pdi.2016.00013.

Abstract

Malnutrition, inflammation, and anemia are common in peritoneal dialysis (PD) patients. In this study, correlations between Malnutrition Inflammation Score (MIS), laboratory and anthropometric parameters, and anemia indices in Croatian PD patients were analyzed. One hundred and one PD patients (males/females 54/47, age 58.71 ± 14.68 years, mean PD duration 21.82 ± 21.71 months) were included. Clinical, laboratory, and anthropometric parameters were measured. Statistically significant correlations between MIS and erythropoietin weekly dose per kg of body weight (ESA weekly dose), hemoglobin (Hb), and erythrocytes were found ( = 0.439, < 0.001; = -0.032, < 0.001; = -0.435, < 0.001), respectively. Also, statistically significant correlations were found between MIS and mean corpuscular volume ( = 0.344, < 0.001), iron ( = -0.229, = 0.021), and total iron binding capacity (TIBC) ( = -0.362, < 0.001), respectively. Furthermore, statistically significant correlations between ESA weekly dose and serum albumin level and body mass index (BMI) were found ( = -0.272, = 0.006; = -0.269, = 0.006), respectively. When we divided PD patients into 2 groups according Hb level (Hb ≥ 110 [ = 60, 59.41 %]) and Hb < 110 [ = 41, 40.59%]), statistically significant differences were found in MIS score (3.02 ± 2.54 vs 4.54 ± 3.54, = 0.014), C-reactive protein (CRP) (3.52 ± 6.36 vs 7.85 ± 7.96, = 0.005), and serum albumin level (44.22 ± 8.54 vs 39.94 ± 8.56, = 0.003), respectively. Our findings suggest that anemia is correlated with malnutrition and inflammation in Croatian PD patients. Further studies are needed to assess whether modulating inflammatory or nutritional processes can improve anemia management in PD patients.

摘要

营养不良、炎症和贫血在腹膜透析(PD)患者中很常见。在本研究中,分析了克罗地亚PD患者的营养不良炎症评分(MIS)、实验室及人体测量参数与贫血指标之间的相关性。纳入了101例PD患者(男性/女性为54/47,年龄58.71±14.68岁,平均PD病程21.82±21.71个月)。测量了临床、实验室和人体测量参数。发现MIS与每千克体重促红细胞生成素每周剂量(ESA每周剂量)、血红蛋白(Hb)和红细胞之间存在统计学显著相关性(分别为r = 0.439,P < 0.001;r = -0.032,P < 0.001;r = -0.435,P < 0.001)。此外,还发现MIS与平均红细胞体积(r = 0.344,P < 0.001)、铁(r = -0.229,P = 0.021)和总铁结合力(TIBC)(r = -0.362,P < 0.001)之间分别存在统计学显著相关性。此外,还发现ESA每周剂量与血清白蛋白水平和体重指数(BMI)之间分别存在统计学显著相关性(r = -0.272,P = 0.006;r = -0.269,P = 0.006)。当我们根据Hb水平将PD患者分为两组(Hb≥110 [n = 60,59.41%])和Hb < 110 [n = 41,40.59%])时,发现MIS评分(3.02±2.54 vs 4.54±3.54,P = 0.014)、C反应蛋白(CRP)(3.52±6.36 vs 7.85±7.96,P = 0.005)和血清白蛋白水平(44.22±8.54 vs 39.94±8.56,P = 0.003)分别存在统计学显著差异。我们的研究结果表明,在克罗地亚PD患者中,贫血与营养不良和炎症相关。需要进一步研究以评估调节炎症或营养过程是否可以改善PD患者的贫血管理。

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