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体重指数对腹膜透析患者死亡率、腹膜炎、技术熟练程度和残余肾功能的影响。

The effect of body mass index on mortality, peritonitis, technique proficiency and residual renal function in peritoneal dialysis patients.

机构信息

Department of Nephrology, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey.

出版信息

Int Urol Nephrol. 2024 Jul;56(7):2379-2389. doi: 10.1007/s11255-024-03988-9. Epub 2024 Mar 2.

Abstract

BACKGROUND

The prevalence of obesity is increasing worldwide. Obesity is also increasing in the chronic kidney disease (CKD) population. There are conflicting data on complications such as mortality, peritonitis, and technique proficiency of peritoneal dialysis (PD) in underweight and obese patients according to body mass index (BMI). We aimed to present the data in our region to the literature by comparing the residual renal function (RRF), peritonitis, technique proficiency, and mortality rates of the patients we grouped according to BMI.

METHODS

The data of 404 patients who were started and followed up in our clinic between March 2005 and November 2021 were evaluated retrospectively. They were grouped as underweight, normal weight, overweight, and obese according to BMI. RRF, mortality, technique proficiency and peritonitis data of the groups were compared.

RESULTS

Of the 404 patients, 44 were underweight, 199 were normal weight, 110 were overweight, and 55 were obese. No difference was found between the groups in the technique survey and in the time to first peritonitis with Kaplan-Meier analysis (respectively; p = 0.610, p = 0.445). Multivariate Cox regression analysis showed that BMI did not affect mortality (HR 1.196 [95% CI 0.722-1.981] (p = 0.488)).

CONCLUSION

In conclusion, we report that BMI has no effect on RRF, peritonitis, technique proficiency, and mortality in patients undergoing PD, and that mortality may depend on additional factors such as mean albumin, time to first peritonitis, and loss of RRF.

摘要

背景

肥胖症在全球范围内的患病率正在上升。慢性肾脏病(CKD)人群中的肥胖症也在增加。根据体重指数(BMI),超重和肥胖患者的死亡率、腹膜炎和腹膜透析(PD)技术熟练程度等并发症的数据存在冲突。我们旨在通过比较根据 BMI 分组的患者的残余肾功能(RRF)、腹膜炎、技术熟练程度和死亡率,将我们地区的数据与文献进行比较。

方法

回顾性分析 2005 年 3 月至 2021 年 11 月在我们诊所开始和随访的 404 名患者的数据。他们根据 BMI 分为体重不足、正常体重、超重和肥胖。比较了各组的 RRF、死亡率、技术熟练程度和腹膜炎数据。

结果

在 404 名患者中,44 人体重不足,199 人正常体重,110 人超重,55 人肥胖。通过 Kaplan-Meier 分析,各组之间在技术调查和首次腹膜炎时间方面没有差异(分别为 p=0.610,p=0.445)。多变量 Cox 回归分析显示,BMI 并不影响死亡率(HR 1.196 [95% CI 0.722-1.981](p=0.488))。

结论

总之,我们报告 BMI 对 PD 患者的 RRF、腹膜炎、技术熟练程度和死亡率没有影响,死亡率可能取决于其他因素,如平均白蛋白、首次腹膜炎时间和 RRF 丧失。

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