Xu Lixing, Ng Jack Kit-Chung, Chan Gordon Chun-Kau, Fung Winston Wing-Shing, Chow Kai-Ming, Szeto Cheuk-Chun
Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
BMC Nephrol. 2025 Jul 22;26(1):411. doi: 10.1186/s12882-025-04350-6.
Muscle wasting has been linked to negative clinical outcomes in patients undergoing peritoneal dialysis (PD). However, it remains unclear how early changes in muscle mass after the initiation of PD affects the clinical outcome. This study aimed to identify factors influencing changes in lean tissue mass (LTM) over six months in new PD patients and to assess their prognostic significance.
We conducted a study of 90 new PD patients. Over a six-month period, we recorded changes in LTM and adipose tissue mass (ATM) using bioimpedance spectrometry. Outcome measures included patient and technique survival rates.
After 6 months of PD, body weight and body mass index remained unchanged, but 42 patients (46.7%) had decrease in LTM for ≥ 1 kg. The percentage of LTM (LTMp) also dropped from 63.4 ± 13.6% to 61.5 ± 13.4% (p = 0.006), accompanied by an increase in ATM. Multiple linear regression models showed a strong correlation between changes in LTM and ATM; for every 1 kg increase in ATM, there was a 1.01 kg decrease in LTM (95% confidence interval: 0.797 to 0.855, p < 0.0001). However, the change in LTM during the first six months of PD was not associated with patient or technique survival rates.
Although the overall body weight was static, there was a trend of reduction in LTM and a concommitant increase in ATM during the first 6 months of PD. However, these changes were not associated with adverse clinical outcome.
肌肉消耗与接受腹膜透析（PD）的患者的不良临床结局相关。然而，PD开始后肌肉质量的早期变化如何影响临床结局仍不清楚。本研究旨在确定影响新PD患者六个月内瘦组织质量（LTM）变化的因素，并评估其预后意义。
我们对90例新的PD患者进行了研究。在六个月的时间里，我们使用生物电阻抗光谱法记录了LTM和脂肪组织质量（ATM）的变化。结局指标包括患者生存率和技术生存率。
PD 6个月后，体重和体重指数保持不变，但42例患者（46.7%）的LTM下降≥1 kg。LTM百分比（LTMp）也从63.4±13.6%降至61.5±13.4%（p = 0.006），同时ATM增加。多元线性回归模型显示LTM和ATM的变化之间存在强相关性；ATM每增加1 kg，LTM就减少1.01 kg（95%置信区间：0.797至0.855，p < 0.0001）。然而，PD前六个月LTM的变化与患者生存率或技术生存率无关。
尽管总体体重保持不变，但在PD的前6个月中，LTM有下降趋势，同时ATM相应增加。然而，这些变化与不良临床结局无关。
