Li Jia-Lin, Cai Zhen, Zhao Jing, Zhu Xiang-Gang, Li Qian, Li Yan-Shuang, Liu Meng-Chao, Cui Fang-Qiang, Zhao Wen-Jing, Niu Wen-Quan
Department of Nephropathy, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China.
Front Physiol. 2023 Jul 27;14:1170537. doi: 10.3389/fphys.2023.1170537. eCollection 2023.
The study aimed to examine the association of three anemia-related biomarkers with the adequacy of peritoneal dialysis (PD) in patients with chronic kidney disease (CKD). This study included 127 PD patients. The total Kt/V urea (Kt/V) was calculated according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. All patients were classified into two groups based on Kt/V, viz., adequate (Kt/V ≥1.7) and inadequate (Kt/V <1.7) groups. Effect sizes are expressed as odds ratios (ORs) and 95% confidence interval (CI). After adjusting for age, gender, hypertension, diabetes, and PD duration, 20 g/L increment in hemoglobin (Hgb) was observed to significantly reduce the risk of inadequate PD by 19% (OR; 95% CI; P: 0.81; 0.70 to 0.95; 0.009), 5 g/L increment in the mean corpuscular hemoglobin concentration (MCHC) by 7% (0.93; 0.88 to 0.98; 0.009), and 5% increment in transferrin saturation (TS) by 23% (0.77; 0.64 to 0.94; 0.012). The gender-specific nomogram model was constructed by incorporating three significant anemia-related biomarkers and convenient influencing factors, and the prediction accuracy was good (concordance index (C-index): 0.686 for men and 0.825 for women). Our findings indicate that the deterioration of three anemia-related biomarkers (Hgb, MCHC, and TS) can precipitate the development of inadequate PD in Chinese patients with CKD.
该研究旨在探讨三种贫血相关生物标志物与慢性肾脏病（CKD）患者腹膜透析（PD）充分性之间的关联。本研究纳入了127例PD患者。根据肾脏病预后质量倡议（K/DOQI）指南计算总尿素清除率（Kt/V）。所有患者根据Kt/V分为两组，即充分组（Kt/V≥1.7）和不充分组（Kt/V<1.7）。效应大小以比值比（OR）和95%置信区间（CI）表示。在调整年龄、性别、高血压、糖尿病和PD时长后，观察到血红蛋白（Hgb）每增加20 g/L可使PD不充分风险显著降低19%（OR；95%CI；P：0.81；0.70至0.95；0.009），平均红细胞血红蛋白浓度（MCHC）每增加5 g/L可使风险降低7%（0.93；0.88至0.98；0.009），转铁蛋白饱和度（TS）每增加5%可使风险降低23%（0.77；0.64至0.94；0.012）。通过纳入三种重要的贫血相关生物标志物和便捷的影响因素构建了性别特异性列线图模型，预测准确性良好（一致性指数（C指数）：男性为0.686，女性为0.825）。我们的研究结果表明，三种贫血相关生物标志物（Hgb、MCHC和TS）的恶化可促使中国CKD患者发生PD不充分。
