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与持续性非卧床腹膜透析患者营养不良相关的营养预测因素。

Nutritional predictors associated with malnutrition in continuous ambulatory peritoneal dialysis patients.

机构信息

Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.

Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.

出版信息

Clin Nutr ESPEN. 2021 Oct;45:454-461. doi: 10.1016/j.clnesp.2021.06.033. Epub 2021 Jul 10.

Abstract

BACKGROUND

Currently in China, out of the total dialysis population, approximately 20% represents continuous ambulatory peritoneal dialysis (CAPD) and almost half of CAPD patients was affected by malnutrition. This study aimed to investigate the association between nutritional predictors and malnutrition with 5.1 years of dialysis according to the subjective global assessment (SGA) in continuous ambulatory peritoneal dialysis (CAPD) patients.

METHODS

A cross-sectional study was conducted from April 2013 to May 2018 and included 70 CAPD patients. The relationship between anthropometric and biochemical parameters with malnutrition was assessed by multiple logistic regression analysis.

RESULTS

The prevalence of malnutrition in CAPD patients was 52.9%. Our result revealed a 7.05-fold increased odds of malnutrition for patients with protein equivalent of total nitrogen appearance normalized to body weight (nPNA) < 1.0 g/kg per day (d) versus patients with normal nPNA (confidence interval (CI) 1.33-37.34; p < 0.05). Patients whose normalized protein catabolic rate (nPCR) was <1.2 g/(kg/d) had a significant positive association with malnutrition versus patients with normal nPCR (adjusted odds ratio (OR) 7.99; p < 0.05). Patients with dietary protein intake (DPI) < 1.0 g/(kg/d) had a higher likelihood of malnutrition than those with normal DPI (OR 12.73; p < 0.05). CAPD patients with upper arm circumference (UAC) < 23.2 cm had a high risk of malnutrition versus patients with normal UAC (OR 12.99; p < 0.05).

CONCLUSIONS

Our study suggested a close association between nPNA, DPI, nPCR, and UAC and malnutrition in CAPD patients. Further studies can be warranted the use of these variables as predictors and a malnutrition consequence among Chinese CAPD patients.

摘要

背景

目前在中国,透析患者中约有 20%为持续非卧床腹膜透析(CAPD)患者,几乎一半的 CAPD 患者存在营养不良。本研究旨在根据主观整体评估(SGA)调查 CAPD 患者透析 5.1 年后,与营养相关的预测因子与营养不良之间的关系。

方法

这是一项 2013 年 4 月至 2018 年 5 月进行的横断面研究,共纳入 70 例 CAPD 患者。采用多因素 logistic 回归分析评估人体测量学和生化参数与营养不良的关系。

结果

CAPD 患者营养不良的患病率为 52.9%。结果显示,nPNA(蛋白氮表现量与体重标准化)<1.0g/kg/d 的患者发生营养不良的风险是 nPNA 正常患者的 7.05 倍(置信区间 1.33-37.34;p<0.05)。nPCR(标准化蛋白分解率)<1.2g/(kg/d)的患者发生营养不良的风险显著高于 nPCR 正常患者(校正优势比 7.99;p<0.05)。DPI(饮食蛋白摄入)<1.0g/(kg/d)的患者发生营养不良的可能性高于 DPI 正常患者(OR 12.73;p<0.05)。UAC(上臂围)<23.2cm 的 CAPD 患者发生营养不良的风险高于 UAC 正常患者(OR 12.99;p<0.05)。

结论

本研究提示 nPNA、DPI、nPCR 和 UAC 与 CAPD 患者的营养不良密切相关。进一步的研究可以验证这些变量作为预测因子和中国 CAPD 患者营养不良后果的有效性。

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