腹膜清除效能与腹膜透析患者营养状况的关系

Correlation between peritoneal clearance efficiency and nutrition indices of continuous ambulatory peritoneal dialysis

目的 回顾性分析腹膜清除效能与腹膜透析患者营养状况之间的关系。方法 选 取本院99例310例次行腹膜透析患者的随访资料,分别计算各例次的腹膜清除效能指标:腹膜尿 素Kt/v和腹膜Ccr。以蛋白呈现率(nPNA)、白蛋白、瘦体重百分比(%LBM)及主观综合评价法评 估营养状况;根据总尿素Kt/v分组,分析腹膜清除效能与营养状况间之的相关性。结果 A组 (Kt/v<1.7)的腹膜Kt/v、Ccr与白蛋白、%LBM、nPNA呈正相关;B组(1.7≤Kt/v≤2.0)腹膜Kt/ v、Ccr与白蛋白呈负相关;C组(Kt/v>2.0)腹膜Kt/v、Ccr与nPNA、%LMB呈正相关。结论 腹膜 清除效能与腹透患者营养状况之间在一定范围内呈负相关性,过高的腹膜清除对腹透患者的营养 状态并无益处。

s Objective To investigate correlation between peritoneal clearance efficiency and nutrition parameters of continuous ambulatory peritoneal dialysis.Methods Ninety-nine patients were enrolled and the follow-up data of 310 dialyses were retrospectively analyzed.The cases were categorized into 3 groups according to dialysis adequacy: group A (Kt/v<1.7),group B (1.7≤ Kt/v≤2.0) and group C (Kt/v>2.0).Dialysis adequacy was calculated by peritoneal clearance and nutrition indices,including Kpt/v,creatinine clearance (Cpcr),normalized protein nitrogen appearance,percentage of lean body mass and serum albumin level.Results In group A and C,there was a positive correlation between peritoneal clearance and nPNA,albumine and %LMB.However,a negative correlation between albumin and peritoneal clearance in group B was identified.Conclusion The peritoneal clearance efficiency might have a negative impact on selected nutrition indices of continuous ambulatory dialysis patients,thus high dialysis dosage shouldn’t be recommended.