Zhao Huiping, Zhao Yuchao, Wu Bei, Bai Li, Lu Lixia, Zuo Li
Department of Nephrology, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing 100044, China.
J Clin Med. 2024 Nov 24;13(23):7104. doi: 10.3390/jcm13237104.
: Renal anemia is linked to a decreased lifespan of red blood cells. The factors influencing red blood cell lifespan (RBCLS) in peritoneal dialysis patients, particularly the connection between inflammation and RBCLS, are still not well understood. This cross-sectional study was conducted to investigate these relationships. : Patients who had been undergoing peritoneal dialysis for more than 3 months were selected for this study. The carbon monoxide exhalation method was used to detect the life span of red blood cells. The patients were then divided into two groups based on whether the RBCLS was shorter than 75 days. General information, anemia-related indicators, and other laboratory indicators along with their treatment were compared between the two groups. The different indicators were then included in a logistic regression analysis to identify independent risk factors that influence the shortening of RBCLS. : A cohort of 59 peritoneal dialysis patients was examined, revealing a median RBCLS of 88 days. Of these patients, 39 exhibited a normal RBCLS, while 20 had a shortened lifespan. A comparison of the two groups indicated that patients with a shorter RBCLS exhibited lower levels of PD vintage (29.5 vs. 56.0, = 0.031), albumin (34.62 ± 3.01 vs. 37.41 ± 3.60, = 0.004), cholesterol (4.02 ± 0.54 vs. 4.55 ± 1.21, = 0.026), and low-density cholesterol (2.19 ± 0.43 vs. 2.75 ± 0.87, = 0.002), and a higher neutrophil-to-lymphocyte ratio (NLR) (3.05 vs. 2.61, = 0.026) compared to those with a normal RBCLS. The logistic regression results indicated that PD vintage (OR 0.976, CI 0.958-0.999), albumin (OR 0.668, CI 0.514-0.867), low-density lipoprotein cholesterol (OR 0.046, CI 0.002-0.953), and NLR (OR 1.792, CI 1.016-3.162) were identified as independent risk factors influencing the shortening of RBCLS. : Hypoalbuminemia, low LDL, and high NLR in peritoneal dialysis patients are identified as independent risk factors associated with a shortened RBCLS. : RBCLS is reduced in both peritoneal dialysis and hemodialysis patients. The neutrophil-to-lymphocyte ratio (NLR) in peripheral blood, a simple and readily available laboratory indicator, can reflect the inflammatory status. : Nutritional status (albumin and LDL) and inflammatory status (NLR) are significant factors that impact the lifespan of red blood cells in peritoneal dialysis patients. : This study presents novel findings on the relationship between chronic inflammation and RBCLS in patients with chronic kidney disease, highlighting the need for additional research in this area.
肾性贫血与红细胞寿命缩短有关。影响腹膜透析患者红细胞寿命（RBCLS）的因素，尤其是炎症与RBCLS之间的联系，目前仍未完全明确。本横断面研究旨在调查这些关系。
选取接受腹膜透析超过3个月的患者进行本研究。采用一氧化碳呼出法检测红细胞寿命。然后根据RBCLS是否短于75天将患者分为两组。比较两组患者的一般信息、贫血相关指标、其他实验室指标及其治疗情况。将不同指标纳入逻辑回归分析，以确定影响RBCLS缩短的独立危险因素。
对59例腹膜透析患者进行了检查，结果显示RBCLS的中位数为88天。其中，39例患者的RBCLS正常，20例患者的寿命缩短。两组比较表明，RBCLS较短的患者腹膜透析时间（29.5 vs. 56.0，P = 0.031）、白蛋白水平（34.62±3.01 vs. 37.41±3.60，P = 0.004）、胆固醇水平（4.02±0.54 vs. 4.55±1.21，P = 0.026）和低密度胆固醇水平（2.19±0.43 vs. 2.75±0.87，P = 0.002）较低，中性粒细胞与淋巴细胞比值（NLR）（3.05 vs. 2.61，P = 0.026）高于RBCLS正常的患者。逻辑回归结果表明，腹膜透析时间（OR 0.976，CI 0.958 - 0.999）、白蛋白（OR 0.668，CI 0.514 - 0.867）、低密度脂蛋白胆固醇（OR 0.046，CI 0.002 - 0.953）和NLR（OR 1.792，CI 1.016 - 3.162）被确定为影响RBCLS缩短的独立危险因素。
腹膜透析患者低白蛋白血症、低LDL和高NLR被确定为与RBCLS缩短相关的独立危险因素。
腹膜透析和血液透析患者的RBCLS均降低。外周血中性粒细胞与淋巴细胞比值（NLR）是一种简单且易于获得的实验室指标，可反映炎症状态。
营养状况（白蛋白和LDL）和炎症状态（NLR）是影响腹膜透析患者红细胞寿命的重要因素。
本研究提出了关于慢性肾脏病患者慢性炎症与RBCLS之间关系的新发现，强调了该领域需要进一步研究。
