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老年腹膜透析患者体重指数变化与死亡率的关系:一项病例对照研究。

The relationship between body mass index changes and mortality in geriatric peritoneal dialysis patients: a case-control study.

作者信息

Bildacı Yelda Deligoz, Korucu Berfu, Oktan Mehmet Ası, Cavdar Caner, Deger Serpil Muge

机构信息

Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Dokuz Eylul University, Izmir, Turkey.

出版信息

BMC Nephrol. 2024 Dec 25;25(1):474. doi: 10.1186/s12882-024-03920-4.

Abstract

BACKGROUND

The prevalence of chronic kidney disease (CKD) is increasing, reflecting the rising incidence of chronic diseases. With the continuous growth of the global geriatric population, a significant portion of individuals with CKD consists of those aged over 65. Regardless of the chosen treatment method, protein-energy loss in patients undergoing renal replacement therapy (RRT) has been associated with elevated morbidity and mortality rates.

METHODS

This is a retrospective, single-center study of incident adult PD patients on peritoneal dialysis (PD) from 1998 to 2022. We aimed to compare the survival outcomes of geriatric patients on PD with changing BMI measurements.

RESULTS

In the geriatric patient group exhibiting a reduced BMI after dialysis initiation, BMI significantly and negatively influenced survival (p = 0.01). The negative effect of BMI on survival was independent of known risk factors such as diabetes mellitus, a history of cardiovascular disease, gender, residual renal function, and history of hemodialysis before peritoneal dialysis (HD before PD) (p = 0.04).

CONCLUSION

Although BMI is easy and extensively measured, it is not considered the perfect monitoring parameter for dialysis patients. However, regular follow-up of BMI, especially in geriatric cases, can be a guiding tool for estimating patients' prognoses.

摘要

背景

慢性肾脏病(CKD)的患病率正在上升,这反映了慢性病发病率的增加。随着全球老年人口的持续增长,很大一部分CKD患者为65岁以上的老年人。无论选择何种治疗方法,接受肾脏替代治疗(RRT)的患者出现蛋白质能量流失都与发病率和死亡率升高有关。

方法

这是一项对1998年至2022年开始接受腹膜透析(PD)的成年新发PD患者进行的回顾性单中心研究。我们旨在比较不同体重指数(BMI)变化的老年PD患者的生存结局。

结果

在透析开始后BMI降低的老年患者组中,BMI对生存有显著的负面影响(p = 0.01)。BMI对生存的负面影响独立于已知的风险因素,如糖尿病、心血管疾病史、性别、残余肾功能以及腹膜透析前的血液透析史(PD前HD)(p = 0.04)。

结论

尽管BMI易于测量且应用广泛,但它并非透析患者的理想监测参数。然而,定期监测BMI,尤其是在老年患者中,可为评估患者预后提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6211/11670478/3e412ffb7959/12882_2024_3920_Fig1_HTML.jpg

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