The Research On Nutritional Status Of Peritoneal Transport Characteristics And The Level Of Trace Elements In Patients With Continuous Ambulatory Peritoneal Dialysis

Objective: Malnutrition was a quite common complication in long-term peritoneal dialysis patients,which could promote disease progression and adverse outcomes.Peritoneal transport characteristics had an important influence on the malnutrition and survival prognosis of patients with chronic kidney disease.In addition,trace elements metabolic disorders was also a vital factor leading to malnutrition of patients with chronic kidney disease,which was a considerable risk for the occurrence of other complications.However,the less related researches about the relationship between peritoneal transport characteristics and trace elements with the nutritional status of dialysis patients were inconsistent.Therefore,the aim of this research was to investigate the relationship between peritoneal transport characteristics and malnutrition in CAPD patients,to observe the distribution of trace elements in the blood,to compare the excretions of trace elements,and to evaluate the effects of distribution and excretion of elements in CAPD patients on the nutritional status.Methods: A total of 137 patients with end stage renal disease undergoing continuous ambulatory peritoneal dialysis were enrolled in this cross sectional research.The results of peritoneal equilibration test were calculated,and the blood,24 h urine,peritoneal dialysate were collected.A number of 37 healthy volunteers were recruited whose blood and urine were collected.The trace elements in the blood,urine and dialysate of patients were detected by inductively coupled plasma mass spectrometry,so did the trace elements in the blood and urine of volunteers.The clinical indicators,biochemical indices were determined by automated biochemical analyzer,and the creatinine in the urine of healthy volunteers was measured.Results: 1.The distribution of peritoneal transport characteristics in this research : 16.2% in the high transport group;31.2% in the high average transport group;36.2% in the low average transport group;16.2% in the low transport group.The albumin of the patients in low transport group and high transport group was higher than that of patients in high average transport group.The cholesterol of patients in low average transport group was higher than that of patients in high average transport group and high transport group.The peritoneal transport characteristics was negatively correlated with triglycerides.2.The concentrations of Al?V?Cr?Mn?Co?Ni?Cu?As?Sr?Mo?Cd?Tl?Pb in the blood of CAPD patients were higher than those of healthy control,and the concentrations of Fe?Zn?Se were lower than those of healthy control,which were statistically significant(P<0.05).The concentrations of Be?Al?V?Cr?Mn?Fe?Ni?Cu?As?Mo?Cd?Sb in the urine of CAPD patients were higher than those of healthy control,and the concentrations of Sr?Tl were lower than those of healthy control,which were statistically significant(P<0.05).The excretions of Be?Al?V?Cr?Mn?Fe?Co?Ni?Cu?Zn?As?Se?Sr?Mo?Cd?Sb?Tl?Pb of CAPD patients with urine from dialysate were higher than those from urine,which were statistically significant(P<0.05).The excretions of Be?Al?V?Cr?Mn?Fe?Ni?Cu?Mo?Sb?Tl?Pb of CAPD patients were higher than those of healthy control,which were statistically significant(P<0.05).Conclusions: 1.The nutritional status of CAPD patients with low transport characteristics may be superior to that with high transport characteristics.In clinical works,the treatment programs should be timely adjusted,combined with nutritional status and based on the peritoneal dialysis characteristics of patients.2.There may be deficiencies of Fe,Zn,Se and accumulation of Al,As,Cd,Tl,Pb and other harmful trace elements in the CAPD patients.Furthermore,due to the loss of renal function,the excretions of trace elements from CAPD patients were mainly through dialysate,which exacerbated the deficiencies of some essential trace elements.Therefore,it was needed to monitor the level of Fe,Zn,Se and other essential trace elements,as well as the level of harmful trace elements such as Al,As,clinically.More researches about the recommended intake of trace elements in this population were needed to provide effective reference.