Hoppe Krzysztof, Schwermer Krzysztof, Kawka Anna, Klysz Patrycja, Baum Ewa, Kaluzna Malgorzata, Sikorska Dorota, Scigacz Anna, Lindholm Bengt, Pawlaczyk Krzysztof, Oko Andrzej
Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland.
Arch Med Sci. 2018 Jun;14(4):807-817. doi: 10.5114/aoms.2016.61902. Epub 2016 Aug 22.
Body mass decomposition and hydration state imbalances affect patients on maintenance dialysis. We compared body composition, hydration and nutritional state of patients on peritoneal dialysis (PD) and hemodialysis (HD) based on dialysis vintage (DV).
Three hundred and fifty-nine prevalent patients on HD ( = 301) and PD ( = 58) were divided into 3 subgroups depending on DV: < 2 years HD ( = 41) and PD ( = 28), 2-4 years HD ( = 111) and PD ( = 17), > 4 years HD ( = 149) and PD ( = 13). Bioimpedance analysis delivered data including overhydration (OH), Lean (LTM) and adipose lipids mass (FAT). Other measurements included daily diuresis (DD), subjective global assessment (SGA) and serum albumin (alb), C-reactive protein (CRP) and total cholesterol (TChol), and hemoglobin (Hb).
Dialysis vintage < 2 years. Hemodialysis patients were older (65.5 ±18.5 vs. 50.9 ±17.1; < 0.01) with a higher mortality (28 vs. 1; < 0.01) and OH (8.0 ±4.3 vs. 1.6 ±3.1; < 0.001). Hemoglobin (10.6 ±1.5 vs. 11.8 ±1.7; < 0.05), TChol (180.2 ±47.0 vs. 211.7 ±46.3; < 0.05), DD (871 ±729 vs. 1695 ±960; < 0.001) and LTM (46.5 ±12.9 vs. 53.8 ±14.4; < 0.05) were lower on HD. Dialysis vintage 2-4 years: when compared to PD, HD patients had higher OH (11.7 ±5.9 vs. 2.1 ±3.2; < 0.001) and lower Hb (10.8 ±1.5 vs. 11.9 ±1.4; < 0.01). Dialysis vintage > 4 years: compared to PD, HD patients had higher LTM (44.3 ±11.7 vs. 38.6 ±7.9; < 0.05) and lower FAT (34.4 ±11.1 vs. 42.8 ±6.4; < 0.01).
Dialysis patients' body composition depends on dialysis modality and DV. Dialysis vintage < 2 years is associated with better hydration, nutritional state, and survival in PD patients, but longer DV reduces these benefits. Dialysis vintage > 4 years associated with similar hydration and mortality in both PD and HD while body composition was better on HD.
体重分解和水合状态失衡会影响维持性透析患者。我们根据透析龄（DV）比较了腹膜透析（PD）和血液透析（HD）患者的身体组成、水合状态和营养状况。
359例HD（n = 301）和PD（n = 58）的现患患者根据DV分为3个亚组：HD < 2年（n = 41）和PD（n = 28），HD 2 - 4年（n = 111）和PD（n = 17），HD > 4年（n = 149）和PD（n = 13）。生物电阻抗分析提供的数据包括水过多（OH）、瘦体重（LTM）和脂肪脂质质量（FAT）。其他测量指标包括每日尿量（DD）、主观全面评定（SGA）以及血清白蛋白（alb）、C反应蛋白（CRP）、总胆固醇（TChol）和血红蛋白（Hb）。
透析龄< 2年。HD患者年龄更大（65.5±18.5 vs. 50.9±17.1；P < 0.01），死亡率更高（28 vs. 1；P < 0.01）且OH更高（8.0±4.3 vs. 1.6±3.1；P < 0.001）。HD患者的血红蛋白（10.6±1.5 vs. 11.8±1.7；P < 0.05）、TChol（180.2±47.0 vs. 211.7±46.3；P < 0.05）、DD（871±729 vs. 1695±960；P < 0.001）和LTM（46.5±12.9 vs. 53.8±14.4；P < 0.05）更低。透析龄2 - 4年：与PD相比，HD患者OH更高（11.7±5.9 vs. 2.1±3.2；P < 0.001）且Hb更低（10.8±1.5 vs. 11.9±1.4；P < 0.01）。透析龄> 4年：与PD相比，HD患者LTM更高（44.3±11.7 vs. 38.6±7.9；P < 0.05）且FAT更低（34.4±11.1 vs. 42.8±6.4；P < 0.01）。
透析患者的身体组成取决于透析方式和DV。透析龄< 2年与PD患者更好的水合状态、营养状况和生存率相关，但更长的DV会降低这些益处。透析龄> 4年与PD和HD患者相似的水合状态和死亡率相关，而HD患者的身体组成更好。
