Analysis Of Influencing Factors Of Protein-energy Wasting And Dialysis Effect In Peritoneal Dialysis Patients

Objective Explore the influencing factors of Protein-energy wasting in peritoneal dialysis patients,and analyze the effect of peritoneal dialysis,and look forward to providing a theoretical basis for clinicians to perform PD-related treatments.Methods According to the inclusion and exclusion criteria,86 patients who underwent regular peritoneal dialysis in the Department of Nephrology,Gansu Provincial People’s Hospital from December 2019 to December 2020 were selected as the research objects.Data of 86 PD patients before dialysis and one year after dialysis were collected for comparative study.1.Collecting information and data includes(1)General information: name,gender,age,marital status,and type of concomitant diseases.(2)Laboratory indicators before and after dialysis: hemoglobin,albumin,serum creatinine,blood urea nitrogen,triglycerides,hypersensitivity C-reactive protein(hs-CRP).(3)Human body data measurement: height,weight,and body mass index(BMI)before and after dialysis.After 1 year of dialysis,the middle arm circumference,middle arm muscle circumference,and triceps skinfold thickness were increased.2.According to the PEW diagnostic criteria established by the International Society of Renal Nutrition and Metabolism(ISRNM)expert group in 2008,86 patients were divided into PEW group and non-PEW group after 1 year of dialysis,and PEW was counted Incidence rate,using Logistic regression to analyze the influencing factors of PEW in PD patients.3.Comparison of indicators within and between the two groups of patients before and after dialysis,repeated measurement analysis of variance(normal distribution of measurement data)and Wilcoxon rank sum test(non-normal distribution of measurement data)were used to analyze the effect of dialysis.Results 1.There were 86 selected patients,39 females accounted for 45.3%,47 males accounted for 54.7%,29 people in the PEW group and 57 people in the non-PEW group.The incidence of PEW at 1 year of dialysis was 33.7%;There were statistically significant differences in age,education level,occupation and associated diseases between the two groups(P < 0.05).2.(1)The comparison of the biochemical indicators of the two groups of patients before dialysis showed that the serum creatinine,albumin,and triglycerides in the PEW group were higher than those in the non-PEW group,and the difference in serum creatinine was statistically significant(P<0.05);The comparison of BMI and other laboratory indicators before dialysis between the two groups showed that the BMI of the PEW group was lower than that of the non-PEW group,and the difference was statistically significant(P<0.05).3.Logistic regression analysis showed that age was a risk factor for PEW in peritoneal dialysis patients(OR=5.668,OR95%CI:1.430-22.470,P=0.014),and education level(OR=0.277,OR95%CI: 0.079~0.967,P= 0.044),BMI(OR=0.277,OR95%CI: 0.019~0.280,P<0.001)are protective factors for PEW.4.Comparison of PEW group and non-PEW group before and after dialysis showed that the hemoglobin difference was statistically significant(F=13.289,P<0.001).After dialysis,the hemoglobin increased by 10.9g/L and 10.8g/L;comparison of hemoglobin between the two groups The degree of increase after dialysis was not statistically significant(F=1.842,P=0.178).The difference of serum creatinine between the PEW group and non-PEW group before and after dialysis was statistically significant(F=14.963,P< 0.001),which respectively decreased by 90.3umol/L and 104.5umol/L.The decrease degree of serum creatinine after dialysis was not statistically significant between the two groups(F=3.687,P=0.058).5.The difference in blood urea nitrogen between the PEW group and the non-PEW group before and after dialysis was statistically significant(Z=1.979,P=0.048,Z=2.729,P=0.006),and the decrease was 3.6mmol/L and 3.5mmol/L after dialysis;The decrease degree of blood urea nitrogen after dialysis between the two groups was not statistically significant(Z=0.119,P=0.905).Conclusion 1.The incidence of PEW in patients after 1 year of peritoneal dialysis is 33.7%,which is basically consistent with the results of domestic and foreign studies;2.Age is a risk factor for PEW in peritoneal dialysis patients,while education level and BMI are protective factors for PEW;3.Peritoneal dialysis can effectively protect patients’ residual renal function.