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维持性血液透析患者营养不良和炎症状态进展对不良事件和死亡率的影响。

Effect of Progression in Malnutrition and Inflammatory Conditions on Adverse Events and Mortality in Patients on Maintenance Hemodialysis.

机构信息

Division of Kidney and Dialysis, Meiwa Hospital, Nishinomiya, Japan.

Department of Nephrology, Gojinkai-Sumiyoshigawa Hospital, Kobe, Japan,

出版信息

Blood Purif. 2019;47 Suppl 2:3-11. doi: 10.1159/000496629. Epub 2019 Apr 3.

Abstract

BACKGROUND/AIM: In maintenance hemodialysis (MHD), protein-energy malnutrition and chronic inflammation can be critical and are two of the main causes of mortality.

METHOD

We compared the change in nutrition and inflammatory conditions between younger and older MHD patients during a 2-year period. Furthermore, using Kaplan-Meier analysis, we evaluated the correlations between changes in each parameter and any adverse events.

RESULT

During the observational period, body mass index (BMI) and serum albumin levels decreased significantly in older patients. In Kaplan-Meier analysis, patients who showed a decline in BMI had an associated elevated risk for cerebro-cardiovascular disease and hospitalization. Moreover, patients who showed a decline in albumin also had an associated higher risk for infectious disease and hospitalization.

CONCLUSION

This study revealed that the downward trend in nutritional status was prominent in elderly patients. Furthermore, changes in nutritional and inflammatory conditions during MHD were associated with adverse events in MHD patients.

摘要

背景/目的:在维持性血液透析(MHD)中,蛋白质能量营养不良和慢性炎症可能是关键问题,也是导致死亡率的两个主要原因。

方法

我们比较了 2 年内年轻和老年 MHD 患者的营养和炎症状况变化。此外,我们还使用 Kaplan-Meier 分析评估了每个参数变化与任何不良事件之间的相关性。

结果

在观察期间,老年患者的体重指数(BMI)和血清白蛋白水平显著下降。在 Kaplan-Meier 分析中,BMI 下降的患者发生脑血管疾病和住院的风险增加。此外,白蛋白下降的患者发生感染性疾病和住院的风险也较高。

结论

本研究表明,营养状况的下降趋势在老年患者中更为明显。此外,MHD 期间营养和炎症状况的变化与 MHD 患者的不良事件有关。

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