As'habi Atefeh, Najafi Iraj, Tabibi Hadi, Hedayati Mehdi
Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2019 Jan;13(1):48-55.
Protein-energy wasting (PEW) is prevalent in dialysis patients, and cardiovascular disease (CVD) is the leading cause of mortality in these patients. This study aimed to determine the prevalence of PEW and its relationship with CVD risk factors in peritoneal dialysis (PD) patients in Tehran, Iran.
All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. The diagnosis of PEW was done based on the criteria of the International Society of Renal Nutrition and Metabolism. Serum high-sensitivity C-reactive protein, soluble intercellular adhesion molecule type 1, malondialdehyde, and lipid profile were measured.
The prevalence of PEW was 29% in the PD patients. Significant associations were found between the prevalence of PEW in PD patients and sex (P = .01), age (P = .03), type of PD dialysis solution (P = .04), and microinflammation (P = .03). Serum C-reactive protein (P = .02), soluble intercellular adhesion molecule type 1 (P = .001), and triglyceride (P = .03) were significantly higher in the PD patients without PEW as compared to those with PEW, whereas high-density lipoprotein cholesterol level was significantly lower in the PD patients without PEW as compared to those with PEW (P = .003).
Our study shows that PEW is prevalent in Iranian PD patients. In addition, serum concentrations of CVD risk factors are dependent on the amount of glucose absorbed from PD solutions and are more impaired in PD patients without PEW as compared to those with PEW.
蛋白质能量消耗(PEW)在透析患者中普遍存在,而心血管疾病(CVD)是这些患者死亡的主要原因。本研究旨在确定伊朗德黑兰腹膜透析(PD)患者中PEW的患病率及其与CVD危险因素的关系。
本横断面研究纳入了德黑兰所有符合条件的腹膜透析中心的PD患者。PEW的诊断依据国际肾脏营养与代谢学会的标准进行。检测血清高敏C反应蛋白、可溶性细胞间黏附分子1、丙二醛和血脂谱。
PD患者中PEW的患病率为29%。发现PD患者中PEW的患病率与性别(P = 0.01)、年龄(P = 0.03)、PD透析液类型(P = 0.04)和微炎症(P = 0.03)之间存在显著关联。与有PEW的PD患者相比,无PEW的PD患者血清C反应蛋白(P = 0.02)、可溶性细胞间黏附分子1(P = 0.001)和甘油三酯(P = 0.03)显著更高,而无PEW的PD患者高密度脂蛋白胆固醇水平与有PEW的患者相比显著更低(P = 0.003)。
我们的研究表明PEW在伊朗PD患者中普遍存在。此外,CVD危险因素的血清浓度取决于从PD溶液中吸收的葡萄糖量,与有PEW的PD患者相比,无PEW的患者受损更严重。