膳食能量摄入可预测中国腹膜透析患者的死亡率：一项单中心18年随访研究。

Dietary energy intake predicts mortality in Chinese patients with peritoneal dialysis: a single-center 18 years' follow-up study.

作者信息

Liu Su-Xuan, Xu Ke, Lu Meng-Yuan, Zhang Xiao-Qing, Su Chun-Yan, Tang Wen

机构信息

Department of Nephrology, Peking University Third Hospital, Beijing, China.

出版信息

BMC Nephrol. 2025 Mar 5;26(1):120. doi: 10.1186/s12882-025-04051-0.

DOI:10.1186/s12882-025-04051-0

PMID:40045238

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11884108/

Abstract

BACKGROUND

Lower dietary energy intake (DEI) may be associated with increased mortality risk. This study aims to analyze the influence of baseline DEI, time average DEI, and other factors on survival in peritoneal dialysis (PD) patients.

METHOD

It was a single-center retrospective cohort study. Patients who started PD from January 2006 to June 2021 were included in this study and followed up until June 2023. Their baseline (six months after the beginning of PD) demographic, dietary intake, laboratory data, and time varying dietary intake data were collected and analyzed. The relationships between these data and survival were examined using Cox model to estimate death hazard ratios.

RESULT

A total of 794 patients were included in this study, 424 males and 370 females, with a mean age of 58.87 ± 16.02 years. Their mean normalize baseline dietary energy intake (nDEI) was 25.46 ± 6.72 kcal/kg/day, time average nDEI was 24.87 ± 4.74 kcal/kg/day. The median follow-up duration was 46.58 (27.38, 78.52) months in the overall cohort. Based on multivariate Cox proportional hazard analysis, age (HR = 1.056, 95% Cl = 1.047-1.065, p < 0.001), diabetes (HR = 1.364, 95% Cl = 1.114-1.671, p = 0.003), serum albumin (HR = 0.945, 95% Cl = 0.923-0.967, p < 0.001), blood sodium (HR = 0.973, 95% Cl = 0.954-0.992, p = 0.002), serum urea (HR = 0.974, 95% Cl = 0.953-0.994, p = 0.025), and baseline nDEI (HR = 0.980, 95% Cl = 0.964-0.996, p = 0.017) were significantly associated with mortality. Baseline DPI, BMI and time average nDEI were not related to PD patients' survival. When classified baseline nDEI into 4 groups (< 25 kcal/kg/day, 25-29.99 kcal/kg/day, 30-34.99 kcal/kg/day, and ≥ 35 kcal/kg/day), the univariate and multivariate Cox proportional hazard analysis showed that the patients with nDEI 30-34.99 kcal/kg/day had the lowest mortality risk (using the DEI < 25 kcal/kg/day group as reference, p < 0.05).

CONCLUSION

Our study revealed that DEI 30-34.99 kcal/kg/day might be beneficial to the long-term outcome for the Chinese PD population.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

较低的膳食能量摄入（DEI）可能与死亡风险增加有关。本研究旨在分析基线DEI、时间平均DEI及其他因素对腹膜透析（PD）患者生存的影响。

方法

这是一项单中心回顾性队列研究。纳入2006年1月至2021年6月开始行PD的患者，并随访至2023年6月。收集并分析他们的基线（PD开始后6个月）人口统计学、饮食摄入、实验室数据以及随时间变化的饮食摄入数据。使用Cox模型检验这些数据与生存之间的关系，以估计死亡风险比。

结果

本研究共纳入794例患者，其中男性424例，女性370例，平均年龄58.87±16.02岁。他们的平均标准化基线膳食能量摄入（nDEI）为25.46±6.72千卡/千克/天，时间平均nDEI为24.87±4.74千卡/千克/天。整个队列的中位随访时间为46.58（27.38，78.52）个月。基于多因素Cox比例风险分析，年龄（HR = 1.056，95%CI = 1.047 - 1.065，p < 0.001）、糖尿病（HR = 1.364，95%CI = 1.114 - 1.671，p = 0.003）、血清白蛋白（HR = 0.945，95%CI = 0.923 - 0.967，p < 0.001）、血钠（HR = 0.973，95%CI = 0.954 - 0.992，p = 0.002）、血清尿素（HR = 0.974，95%CI = 0.953 - 0.994，p = 0.025）和基线nDEI（HR = 0.980，95%CI = 0.964 - 0.996，p = 0.017）与死亡率显著相关。基线DPI、BMI和时间平均nDEI与PD患者的生存无关。将基线nDEI分为4组（<25千卡/千克/天、25 - 29.99千卡/千克/天、30 - 34.99千卡/千克/天和≥35千卡/千克/天）后，单因素和多因素Cox比例风险分析显示，nDEI为30 - 34.99千卡/千克/天的患者死亡风险最低（以DEI<25千卡/千克/天组为参照，p < 0.05）。