The Effect Of Different Residual Renal Function On Nutritional Status And Microinflammation State Of Patients With Peritoneal Dialysis

Objective: To observe the correlation between residual renal function(RRF) and albumin,prealbumin,serum creatinine,blood urea nitrogen which represent the index of nutritional status and to analysis the effect of residual renal function on nutritional Status of patients with peritoneal dialysis;To observe the relation between residual renal function and high sensitive c-reactive protein (hsCRP) , interleukin-6(IL-6).To demonstrate the relation between residual renal function and microinflammation state of patients with peritoneal dialysis.Methods: Forty-six patients were selected,who undergone peritoneal dialysis for more than three months and acute infections,serious heart failure,liver pathological changes,trauma were excluded.Glomerular filtration rate(GFR) were calculated as the index of residual renal function.Urea kinetics(KT/V) per week of patients were calculated as the index of dialysis sufficient extent. Serum albumin(Alb) ,prealbumin(PA),total cholesterol(TC),serum creatinine (Scr),urea nitrogen(BUN),the protein equivalent of nitrogen appearance(PNA) were measured during the corresponding time.Nutritional status were compared between peritoneal dialysis group and health group. To analysis the effect of RRF on Serum albumin,serum creatinine of patients with peritoneal dialysis.hsCRP and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) as the index of microinflammation state,which were compared between peritoneal dialysis group and health group. To analysis the effect of RRF and KT/V on microinflammation state.Result:1,Serum albumin level of peritoneal dialysis group was obviously lower than that of health group(P<0.01) . Serum creatinine and urea nitrogen of peritoneal dialysis group were obviously higher than that of health group(P<0.01). RRF was positively correlated with KT/V,creatinine clearance rate per week of patients( Ccr/w),residual urine volume(P<0.01).RRF was negatively correlated with ultrafiltration volume and dialysis time(P<0.01).RRF was positively correlated with Alb,PA,protein equivalent of total nitrogen appearance(PNA)(P<0.01 ). According to the RRF level,these patients were divided into two groups,RRF≥2.5ml/min group and RRF<2.5ml/min group.The level of Alb,Scr,protein equivalent of total nitrogen appearance(PNA) in RRF≥2.5ml/min group were significantly higher than that of the RRF<2.5ml/min group(P<0.01).2,The hsCRP and IL-6 which represent microinflammation state in peritoneal dialysis group were significantly higher than that of health group(P<0.01).hsCRP was obviously positively correlated with IL-6(P<0.01).RRF was negatively correlated with hsCRP and IL-6 (r=-0.52,r=-0.63,P<0.01).The index of dialysis sufficient extent KT/V was negatively correlated with hs-CRP and IL-6(r=-0.319,r=-0.428,P<0.05,P<0.01).Conclusion:1,Malnutrition is existed in most patients with peritoneal dialysis. RRF was compactly correlated with nutritional status.2,Microinflammation state is existed in patients with peritoneal dialysis to some extent.RRF is a important factor correlated with microinflammation state and is the main way to clean microinflammation factors.