| Objective Diabetes have became one of the most important factors that lead to chronic renal failure,In many countries, one of the first choice of renal replacement therapy for patients with end stage renal failure is peritoneal dialysis.But some studies indicated that there is an internal relation between diabetes and the complications of PD, such as, malnutrition, volume overload, cardiovascular events and peritonitis. The complications of PD for diabetic nephropathy was more serious than other patients, which has become a thorny issue for renal Department of internal medicine clinicians.In this study we choose 36( continue ambulatory peritoneal dialysis CAPD) patients in the nephrology department of XXX hospital as the research subject. We expect to improve quality of life and survival of PD with DN through a comparative analysis of correlation results.Methods In a cross-sectional study,36 patients were treated with PD at least 3 months,Among them,14 case were diabetics and 22 cases were non-diabetics. Assessing patients nutritional condition by subjective global assessment, serum total protein, serum prealbumin and serum album. Assessing patients microinflammatory state through detecting the level of serum high sensitivity C reactive protein(Hs-CRP). Assessing patients volume load through edema of lower extremity.Analyzing the biochemical markers and other routine clinical testing(hemoglobin, serum creatinine, blood urea nitrogen, potassium,calcium,phosphorus) of two group patients. Besides, the incidence of peritonitis in PD patients have also analyzed and compared between two groups.Results(1)The age of the two group of CAPD patients distributes in the 22-65 years, whose dialysis ages distribute in 7-25 months. The difference is not significant in age distribution, gender, duration of dialysis, serum creatinine, blood urea nitrogen, electrolyte imbalance and dialysis adequacy assessment of two groups of patients(P> 0.05).(2)There is remarkable difference in subjective global assessment of nutritional comparison between the diabetics and non- diabetics with PD(P <0.05);In contrast to the group with non-diabetic nephropathy,the one with diabetic nephropathy have lower levels in serum albumin, pre-albumin levels(respectively 31.58±4.39VS35.15±5.23, 280.7±52.51VS325.89±47.94)(P <0.05).(3)Compared with the non-diabetic nephropathy group, the level of Hs-CRP in the diabetic nephropathy group were significantly Higher(5.74±1.82VS4.16±2.35)(P<0.05). High-sensitivity C-reactive protein is associated with total protein, albumin, prealbumin negatively. The correlation coefficient r is(-5.1,-0.62,-0.64),( P <0.05).(4)Differences between the levels of anemia in diabetic patients with peritoneal dialysis groups and non is not statistically significant, P>0.05.(5) There are statistically significant differences between the levels of swelling in diabetic patients with peritoneal dialysis groups and non,( P <0.05)..(6)33.3% patients in this study incided peritonitis(12/36), including 3 non-diabetic patients(13.6%)(3/12), and 9 diabetic ones(64.3%)(9/14) in the past one year.Conclusion Diabetic nephropathy patients undergoing PD have a more obvious high volume、load malnutrition、infection and inflammation and other complications than non-diabetic nephropathy ones.By means of preventive measures in this study, we expect to reduce clinical complications of diabetic patients with peritoneal dialysis. |
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