糖尿病肾脏疾病与非糖尿病肾脏疾病血液透析患者容量负荷与营养状况的比较

Comparative study on volume load and nutritional status in hemodialysis patients with diabetic kidney disease and non-diabetic kidney disease

目的研究糖尿病肾脏疾病(diabetic kidney disease,DKD)血液透析患者的容量负荷及营养状况。方法选取承德医学院附属医院血液净化中心长期规律行血液透析的患者共92例。按肾脏疾病病因分为DKD血液透析组和非DKD血液透析组。应用人体成分分析仪(body composition monitor,BCM)进行人体成分分析以及生化指标评估两组营养状况以及容量负荷。结果与非DKD血液透析组相比,DKD血液透析组平均动脉血压、水负荷值(overhydration,OH)、细胞外水分(extracellular water,ECW)含量增高(P<0.05)。而血清白蛋白、肌肉组织指数(lean tissue index,LTI)及肌肉组织含量(lean tissue mass,LTM)均降低(P<0.05)。结论相对于非DKD血液透析患者,DKD血液透析患者容量负荷过载及营养不良的风险更高。

Objective To study the volume load and nutritional status in hemodialysis patients with diabetic kidney disease(DKD).Methods A total of 92 patients with long-term and regular hemodialysis were selected from Blood Purification Center of The Affiliated Hospital of Chengde Medical College.According to the etiology of kidney disease,those patients were divided into DKD hemodialysis group and non-DKD hemodialysis group.The body composition monitor(BCM)was used to analyze human body composition and the biochemical indexes scale was used to evaluate the nutritional status and volume load of the two groups.Results Compared with the non-DKD hemodialysis group,the mean arterial pressure(MAP),overhydration(OH),and extracellular water(ECW)in the DKD hemodialysis group were higher(P<0.05).However,the indexes of albumin,lean tissue index(LTI),and muscle tissue content(LTM)in the DKD hemodialysis group were lower than those in the non-DKD hemodialysis group(P<0.05).Conclusion Compared with non-DKD hemodialysis patients,DKD hemodialysis patients have a higher risk of volume overload and malnutrition.