Wang Xiujun, Jiang Juan, Ding Yanqiong, Zhang Yanmin, Li Hongbo, Wan Sheng, Li Lulu, Sun Li, Ye Juhua
Quality Control Office, Huanggang Central Hospital Nursing, Huanggang, Hubei Province, China.
Department of Nephrology, Wuhan First Hospital, Wuhan, Hubei Province, China.
Medicine (Baltimore). 2025 Jul 4;104(27):e42922. doi: 10.1097/MD.0000000000042922.
This study aims to evaluate the quality of life (QoL) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and to identify key clinical and nutritional factors associated with poor QoL under routine follow-up management. This retrospective study included 164 clinically stable CAPD patients who had been undergoing dialysis for >3 months at a single center. Patients were assessed using the Subjective Global Assessment tool and classified into good or poor QoL groups. Nutritional status was evaluated through anthropometric measurements (body mass index, triceps skinfold thickness, mid-arm circumference, mid-arm muscle circumference), biochemical indicators (albumin, prealbumin, hemoglobin), and dietary intake records. Dialysis adequacy, residual renal function, and microinflammatory markers (CRP) were also analyzed. Logistic regression was used to identify factors independently associated with poor QoL. Among 164 CAPD patients, 88 (53.66%) were classified as having poor QoL based on Subjective Global Assessment, including 78 with mild to moderate malnutrition and 10 with severe malnutrition. Compared to those with good QoL, these patients were older and had significantly lower body mass index, triceps skinfold thickness, mid-arm circumference, serum albumin, prealbumin, hemoglobin, dietary protein intake, and daily energy intake (DEI) (all P < .05). They also showed reduced residual renal function, lower creatinine clearance, and decreased residual urine volume. Elevated C-reactive protein (CRP > 10 mg/L) was more common in the poor QoL group, indicating a higher prevalence of microinflammatory state. The complication rate was significantly higher in this group (88.64 vs 60.53%, P < .01). Logistic regression identified low DEI (OR = 0.808, P = .013) and elevated CRP (OR = 1.259, P = .037) as independent predictors of poor QoL. Malnutrition is highly prevalent among CAPD patients and is closely associated with poor QoL. Inadequate DEI and microinflammatory status were identified as significant independent risk factors for reduced QoL. Regular nutritional assessment and targeted interventions to improve caloric intake and control inflammation may help enhance overall outcomes and reduce complication rates in this population.
本研究旨在评估持续非卧床腹膜透析（CAPD）患者的生活质量（QoL），并确定在常规随访管理下与生活质量差相关的关键临床和营养因素。这项回顾性研究纳入了164例临床稳定的CAPD患者，这些患者在单一中心接受透析治疗超过3个月。使用主观全面评定工具对患者进行评估，并分为生活质量良好或较差组。通过人体测量（体重指数、肱三头肌皮褶厚度、上臂中部周长、上臂中部肌肉周长）、生化指标（白蛋白、前白蛋白、血红蛋白）和饮食摄入记录来评估营养状况。还分析了透析充分性、残余肾功能和微炎症标志物（CRP）。采用逻辑回归分析来确定与生活质量差独立相关的因素。在164例CAPD患者中，根据主观全面评定，88例（53.66%）被归类为生活质量差，其中78例为轻度至中度营养不良，10例为重度营养不良。与生活质量良好的患者相比，这些患者年龄更大，体重指数、肱三头肌皮褶厚度、上臂中部周长、血清白蛋白、前白蛋白、血红蛋白、饮食蛋白质摄入量和每日能量摄入量（DEI）均显著降低（所有P < .05）。他们还表现出残余肾功能降低、肌酐清除率降低和残余尿量减少。C反应蛋白升高（CRP > 10mg/L）在生活质量差的组中更为常见，表明微炎症状态的患病率更高。该组的并发症发生率显著更高（88.64%对60.53%，P < .01）。逻辑回归分析确定低DEI（OR = 0.808，P = .013）和CRP升高（OR = 1.259，P = .037）是生活质量差的独立预测因素。营养不良在CAPD患者中非常普遍，并且与生活质量差密切相关。DEI不足和微炎症状态被确定为生活质量降低的重要独立危险因素。定期进行营养评估并采取针对性干预措施以提高热量摄入和控制炎症，可能有助于改善该人群的总体结局并降低并发症发生率。
