The Study On The Correlation Between Serum Sodium Concentration And Protein Energy Wasting In Peritoneal Dialysis Patients

Objective:To investigate the relationship between serum sodium concentration and protein energy wasting(PEW)in patients with peritoneal dialysis(PD),and to provide theoretical basis for clinical intervention.Methods:108 patients were collected from June 2015 to December 2016 in the First Hospital of Shanxi Medical University Department of Nephrology,who treated with continuous peritoneal dialysis(PD),According to the inclusion criteria,88 cases were studied.The general conditions of the patients were recorded,including the incidence,sex,age,weight,height,BMI,blood pressure,and dialysis age.The anthropometric parameters of the patients were measured by standard technique [upper arm circumference(AC),triceps skinfold thickness(TSF)and upper arm muscle circumference(AMC)]etc.The biochemical indexes [serum albumin(Alb),serum albumin(PLB),hemoglobin(Hb),hematocrit(MCV)and serum transferrin(TF),serum cholesterol(TC),triglyceride(TG),serum creatinine(SCr)serum high-sensitivity C reactive protein(hs-CRP),serum potassium ion(K),serum calcium(Ca)serum sodium(Na)] etc,and subjective assessment(SGA score)was used to assess the nutritional status of the patients.The prevalence of PEW was calculated according to the diagnostic criteria of ISRMN,according to the average level of blood sodium concentration were divided into A group(serum Na<137mmol/L)and group B(blood Na = 137mmol/L),statistical methods were used to compare the differences of the above indexes and the prevalence rate of PEW between the two groups,pearson method was used to analyze the correlationbetween PD and serum sodium concentration(Na)in patients with PEW.Results:1.There were 48 males and females,aged from 20 to 78 years,mean age(49.6+13.93)years,the dialysis time ranged from 3 to 64 months,with an average age of dialysis(16.25±13.57)months,24 cases of diabetes mellitus,accounting for(27.3%).2.The prevalence of PEW was 39.7% in our hospital.3.There was no significant difference in gender,age,BMI,dialysis age,blood pressure,PLB,TSF,Hb,MCV,TF,TC,TG,SCr,K,Ca,and hs-CRP between the two groups(P >0.05);4.Compared with B group,upper arm circumference,upper arm muscle circumference,serum albumin level were lower in A group,SGA score was higher,the difference was statistically significant(P <0.01);5.The concentration of serum sodium in PD patients was positively correlated with upper arm circumference,upper arm muscle circumference and serum albumin(P <0.01),and negatively correlated with SGA(P <0.01).Conclusion:The incidence of PEW was higher in peritoneal dialysis patients,There was a certain correlation between PEW and serum sodium concentration,and it is suggested that prevention of low sodium levels in patients with PD may reduce the incidence of PEW in a certain extent,improve the prognosis and prolong life.