Kim Moo-Jun, Jeon Jae-Wan, Kim Hae-Ri, Park Hyerim, Han Suyeon, Hwang Yunkyeong, Park Heewon, Park Kyungho, Lee Eu-Jin, Ham Young-Rok, Na Ki-Ryang, Lee Kang-Wook, Choi Dae-Eun
Department of Nephrology, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea.
Department of Medical Science, Chungnam National University, Daejeon 35015, Republic of Korea.
Diagnostics (Basel). 2023 Jul 31;13(15):2545. doi: 10.3390/diagnostics13152545.
Patients undergoing dialysis through a permanent catheter often experience infection or malfunction. However, few studies have clarified the predictors of permanent catheter patency survival in patients undergoing hemodialysis. We assessed the relationship between the parameters of body composition monitoring (BCM), determined before the initiation of dialysis, and the patency survival of the permanent catheters inserted in 179 patients who commenced hemodialysis between 14 January 2020 and 31 August 2021. The relationships between permanent catheter patency at 6 weeks and BCM parameters, laboratory tests, age, sex, comorbidities, and medications at baseline were studied using Kaplan-Meier survival curves. Permanent catheter patency was observed to be superior at high extracellular-to-intracellular (ECW/ICW) ratio ( < 0.005). After adjustment for covariates, the ECW/ICW ratio remained an independent factor associated with permanent catheter patency survival. When patients with non-patent catheters were subdivided into infection and malfunction groups, and the associations of BCM parameters were evaluated in those groups, the ECW/ICW ratio was not significantly associated with permanent catheter patency survival in the infection group ( = 0.327); instead, a significant association was found for the lean tissue index ( < 0.001). In the malfunction group, the ECW/ICW ratio remained significantly associated with permanent catheter patency survival ( < 0.001).
通过永久性导管进行透析的患者经常会发生感染或出现功能故障。然而,很少有研究阐明血液透析患者永久性导管通畅存活的预测因素。我们评估了在透析开始前测定的身体成分监测(BCM)参数与2020年1月14日至2021年8月31日期间开始血液透析的179例患者所插入永久性导管的通畅存活之间的关系。使用Kaplan-Meier生存曲线研究了6周时永久性导管通畅与BCM参数、实验室检查、年龄、性别、合并症和基线用药之间的关系。观察到在高细胞外与细胞内(ECW/ICW)比值(<0.005)时永久性导管通畅情况较好。在对协变量进行调整后,ECW/ICW比值仍然是与永久性导管通畅存活相关的独立因素。当将导管不通畅的患者细分为感染组和功能故障组,并在这些组中评估BCM参数的关联时,ECW/ICW比值在感染组中与永久性导管通畅存活无显著关联(P = 0.327);相反,发现瘦组织指数有显著关联(P < 0.001)。在功能故障组中,ECW/ICW比值仍然与永久性导管通畅存活显著相关(P < 0.001)。