| Objective: In recent years, the chronic kidney disease (CKD)incidence increased year by year.According to the reports，the morbidityof CKD patients in China was about10.8%，similar to foreign’s report.When the CKD develop to4,5period, patients will have renal failure.The5period patients can only maintain their life by renal replacement therapy.The commonly renal replacement therapy methods are peritoneal dialysis,hemodialysis and kidney transplantation. Peritoneal dialysis is one of themost commonly used renal replacement therapy for the end-stage renaldisease (ESRD) patients. It has the following advantages：1. Simpleoperation, wide application range and easy to carry, it does not needspecial equipment and patients can have their own home, so it basicallydoes not affect the work.2. Without the need for systemic use ofanticoagulants, no cardiopulmonary bypass, and hemodynamic changes，more smoothly dialysis and greater security, so it is suitable for thepatients with diabetes or cardiovascular disease as a result of the vascularinvolvement is not suitable for hemodialysis patients.3. Better removal ofmiddle molecular substance. However, long-term peritoneal dialysispatients easily lead to malnutrition and cause severe infections (such asperitonitis) and other serious complications.According to reports in theliterture: the morbidity of the malnutrition in patients with peritonealdialysis was about18%~56%. The incidenec of that in China isabout15%~75%. At the same time diabetes has become one of the mainfactors resulting in chronic renal failure. domestic literature reported thatabout30%~40%diabetic patients can cause Diabetic nephropathy，anddiabetes closely related to the complications such as malnutrition andperitonitis in peritoneal dialysis patients. In many countries, peritoneal dialysis is the first choice Renal replacement therapy of end-stage kidneyfailure patients. So investigation and analysis on long-term peritonealdialysis patients nutrition status is an important subject for kidneymedicine clinical doctors. In this study we choose33CPAD patients inthe nephrology department of Hebei medical university third hospital asthe research object. Using many kinds of index to evaluate and analysisthe patients’nutrition status to get relevant data, for providing reference ofadjustment and improvement of treatment plan for peritoneal dialysis toand improving the patient’s quality of life and survival rate in the future.Method: The study object this research is chronic peritoneal dialysispatients in the nephrology department of Hebei medical university thirdhospital. The research object will be divided into two groups. A group ispatients without diabetes（18people）, another group is peritoneal dialysispatients with diabete（s15people）. We use Cross-sectional survey to studytwo groups of patients’ nutritional status. The primary outcome such as:subjective global assessment of nutritional status (SGA), laboratory index,body measurement indicators, bone mineral density. According to theobservation we can analyse whether there are differences between twogroups of patients and the significance of difference.Results: Two groups of patients was put into each group after thebalance test of age, sex, age of dialysis, KT/V，BMI. The generalcondition of two groups have a good balance（P>0.05）.We use SGAevaluate the nutrition status of two groups of patients. The differences ofresult had statistical significance（P<0.05）. The nutrition status ofdiabetic nephropathy group was worse than the group without diabeticnephropathy；The difference of Hemoglobin test results was statisticallysignifican（tP<0.05）. Diabetic nephropathy group is lower than the groupwithout diabetic nephropathy（98.76±9.435g/l VS106.4±10.693g/l）；The result of serum creatinine, blood urea nitrogen,and serum totalprotein was not statistically significan（tP>0.05）；The difference of serumalbumin, transferrin and prealbumin test results was statistically significant （P<0.05）.Compared with the non-diabetic nephropathygroup,the results of serum albumin and prealbumin of the diabeticnephropathy group were significantly lower （35.1867±4.2352g/lVS40.0667±4.4692g/l；0.3013±0.0674g/l VS0.3728±0.0629g/l）.Serumtransferrin of diabetic nephropathy group was higher than that ofnon-diabetic nephropathy group（2.424±0.6879VS1.9917±0.5197）;Thebone mineral density T value difference of right hip and the left hip jointwas statistically significan between two groups of patients. Comparedwith the non-diabetic nephropathy group， the diabetic nephropathygroup’s T value is much higher（right：2.9267±1.1997VS1.8167±1.228；left：2.6667±1.0715VS1.6722±1.0323）； There was no statisticallysignificant difference of Lumbar joints bone mineral density T valuebetween two groups（P>0.05）；There was no statistically significantdifference in MoCA evaluation（P>0.05）；The survey result of thatwhether the peritoneal dialysis related peritonitis occured over the pastyear had statistically significant difference（P<0.05），The non-diabeticnephropathy group infection rate was11.11%; Diabetic nephropathygroup was73.33%, the infection rate of the diabetic nephropathy groupcan be thought higher than that of non diabetic nephropathy group.Conclusion: Compared with patients without diabetes nephropathy，the nutritional status of diabetic nephropathy patient is different after along time of CAPD. After the balance test of age, sex, age of dialysis andKT/V the nutrition status of diabetic nephropathy CAPD patients wasworse than that of CAPD patients without diabetes nephropathy. And thediabetic nephropathy CAPD patients prone to complications such asinfection and bone mineral density decreased.And that will increasemalnutrition of patients. |
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