Huang Yajuan, Zhang Xing, Tang Xingming, Tang Liwen, Shang Sijia, Wang Xiaoyang, Wen Yueqiang, Feng Xiaoran, Zhou Qian, Su Ning, Zhang Rui
Department of Nephrology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Nephrology, The Affiliated Tung Wah Hospital of Sun Yat-sen University, Dongguan, China.
J Ren Nutr. 2023 Jan;33(1):201-207. doi: 10.1053/j.jrn.2022.03.007. Epub 2022 Mar 31.
A high peritoneal transport status is a risk factor for mortality and causes technical failure in patients on peritoneal dialysis (PD). High peritoneal transport status is associated with malnutrition and inflammation in patients with PD. The prognostic nutritional index (PNI) is a marker determined by the serum albumin level and lymphocyte count in the peripheral blood. The aim of this study is to investigate the association between PNI and high peritoneal transport status in patients with PD.
We retrospectively investigated patients with PD from January 1, 2013 to May 31, 2020, in 4 PD centers. Patients with PD were divided into 2 groups according to PNI quartiles: the low PNI group (PNI ≤ 36.6) and the high PNI group (PNI > 36.6). The demographics and clinical and laboratory baseline data of the 2 groups were collected and compared. The association between PNI and high peritoneal transport status was analyzed by multivariate logistic regression analysis.
A total of 404 patients with PD were enrolled in our study. A total of 77 (19.06%) patients had high peritoneal transport status. After adjusting for age, sex, body mass index, hypertension, diabetes mellitus, residual urine volume, current smoking status, pre-existing cardiovascular disease, hemoglobin, white blood cell count, triglycerides, and intact parathyroid hormone, low PNI levels were significantly associated with high peritoneal transport status (odds ratio 3.42, 95% confidence interval 1.82-5.18, P = .0056). Subgroup analysis showed that there was no interaction among PNI and age, sex, diabetes, body mass index, pre-existing cardiovascular disease, or current smoking.
As a marker for malnutrition and inflammation, a low level of PNI is an independent risk factor for high peritoneal transport status in patients with PD.
高腹膜转运状态是腹膜透析（PD）患者死亡的危险因素，并导致技术失败。高腹膜转运状态与PD患者的营养不良和炎症相关。预后营养指数（PNI）是一种由血清白蛋白水平和外周血淋巴细胞计数决定的标志物。本研究的目的是探讨PD患者中PNI与高腹膜转运状态之间的关联。
我们回顾性调查了2013年1月1日至2020年5月31日期间4个PD中心的PD患者。根据PNI四分位数将PD患者分为2组：低PNI组（PNI≤36.6）和高PNI组（PNI>36.6）。收集并比较两组的人口统计学、临床和实验室基线数据。通过多因素logistic回归分析分析PNI与高腹膜转运状态之间的关联。
本研究共纳入404例PD患者。共有77例（19.06%）患者具有高腹膜转运状态。在调整年龄、性别、体重指数、高血压、糖尿病、残余尿量、当前吸烟状态、既往心血管疾病、血红蛋白、白细胞计数、甘油三酯和完整甲状旁腺激素后，低PNI水平与高腹膜转运状态显著相关（比值比3.42，95%置信区间1.82-5.18，P=.0056）。亚组分析显示，PNI与年龄、性别、糖尿病、体重指数、既往心血管疾病或当前吸烟之间无相互作用。
作为营养不良和炎症的标志物，低水平的PNI是PD患者高腹膜转运状态的独立危险因素。
