Research On Correlation Between Pre-dialysis Serum Sodium And PEW In Maintenance Hemodialysis Patients

Objective:To examined the relationship between pre-dialysis serum sodium and selected nutritional parameters of protein-energy wasting(PEW) in a cohort of maintenance hemodialysis(MHD) patients. Methods:We studied 58 HD patients treated in dialysis units affiliated with First Clinical Hospital of Shanxi Medical University from January 2015 to December 2015. Mean age was 51.6, females 24(41%) and male 34(59%). General information and clinical indexes were assessed in maintenance HD patients using standard techniques, such as triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle circumference(MAMC), handgrip strength(HGS), serum albumin(ALB), transferrin(TRF), hypersensitive C-reactive protein(hs-CRP), serum sodium and blood lipid. The patients were divided into group A and group B according to the mean value of pre-dialysis serum sodium(group A: serum sodium <136.95mmol/L vs. group B: serum sodium >136.95mmol/L). Several statistical methods were employed such as t test and Pearson correlation to compare between the groups and explore the correlation factors, respectively. Results:1. The prevalence of PEW was 46.6% in maintenance HD patients.2. The prevalence rate in group A was significant higher than group B(68% versus 30%, P=0.004).Patients with pre-dialysis serum Na below the mean value(136.95mmol/L) had lower MAC, MAMC, HGS, albumin and transferrin levels(22.48±3.82 cm versus 25.38±3.83 cm, P = 0.047; 20.44±3.14 cm versus 23.00±3.40 cm, P = 0.041; 20.29±9.32 kg versus 28.39±7.35 kg, P = 0.013; 37.84±7.80 g/L versus 43.75±3.78 g/L, P = 0.012 and 1.20±0.36 g/L versus 1.46±0.32 g/L, respectively). Hs-CRP levels in group A was significant higher than group B(9.30±5.07mg/L versus 6.86±3.72mg/L, P = 0.039).3.Pre-dialysis serum Na correlated positively with MAC, MAMC, handgrip and albumin(Pearson’s correlation r = 0.297, P = 0.024; r = 0.304, P = 0.020; r = 0.323, P = 0.014 and r = 0.382, P = 0.003, respectively). Conclusion:This study demonstrates that low serum sodium is associated with protein energy wasting.