Influence of Peritoneal Transport Characteristics on Nutritional Status and Clinical Outcome in Chinese Diabetic Nephropathy Patients on Peritoneal Dialysis  

作　　者：Ji-Chao Guan Wei Bian Xiao-Hui Zhang Zhang-Fei Shou Jiang-Hua Chen 

机构地区：[1]Kidney Disease Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, China [2]Department of Nephrology, Shaoxing People's Hospital, Shaoxing, Zhejiang 312000, China

出　　处：《Chinese Medical Journal》2015年第7期859-864,共6页中华医学杂志（英文版）

基　　金：This work was supported by a grant from the National Natural Science Foundation of China （No. 81170707）.

摘　　要：Background： High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis （PD） patients. However, its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself. The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD. Methods： One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study. According to the initial peritoneal equilibration test result, patients were divided into two groups： Higher transport group （HT, including high and high average transport） and lower transport group （LT, including low and low-average transport）. Demographic characteristics, biochemical data, dialysis adequacy, and nutritional status were evaluated. Clinical outcomes were compared. Risk factors for death-censored technique failure and mortality were analyzed. Results： Compared with LT group （n = 37）, serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group （n = 65） （P 〈 0.05）. Kaplan-Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group. On multivariate Cox analyses, higher peritoneal transport status and lower residual renal function （RRF） were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance （Kt/V）. Independent predictors of mortality were advanced age, anemia, hypoalbuminemia, and lower RRF, but not higher peritoneal transport status. Conclusions： Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD. Higher peritoneal transport status is a significant independent risk factor for death-censored technique failure, buBackground： High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis （PD） patients. However, its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself. The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD. Methods： One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study. According to the initial peritoneal equilibration test result, patients were divided into two groups： Higher transport group （HT, including high and high average transport） and lower transport group （LT, including low and low-average transport）. Demographic characteristics, biochemical data, dialysis adequacy, and nutritional status were evaluated. Clinical outcomes were compared. Risk factors for death-censored technique failure and mortality were analyzed. Results： Compared with LT group （n = 37）, serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group （n = 65） （P 〈 0.05）. Kaplan-Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group. On multivariate Cox analyses, higher peritoneal transport status and lower residual renal function （RRF） were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance （Kt/V）. Independent predictors of mortality were advanced age, anemia, hypoalbuminemia, and lower RRF, but not higher peritoneal transport status. Conclusions： Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD. Higher peritoneal transport status is a significant independent risk factor for death-censored technique failure, bu

关 键 词：Diabetic Nephropathy NUTRITION OUTCOME Peritoneal Dialysis Peritoneal Equilibration Test 

分 类 号：O658[理学—分析化学] Q581[理学—化学]