Assessment Of Physical Activity And Nutritional Status In Chinese Peritoneal Dialysis Patients

Aim:Our study aimed to evaluate physical activity and nutritional status of peritoneal dialysis(PD)patients followed up by our center,and to explore the correlation between them.Methods:A retrospective observational study of Geriatric Nutritional Risk Index(GNRI)as a nutritional status assessment tool from peritoneal dialysis patients in our center from January 1,2005 to December 31,2016 validated evaluation effectiveness and relationship to prognosis.And we investigated the situation of 309 PD patients who were followed up from September 1st,2017 to September 1st,2018 in our center and evaluated physical activity for the first time using Rapid Assessment of Physical Activity(RAPA)and 30"sit-to-stand test(30"STS).According to different capacity of action,we divided patients into three groups and compared among them.Spearman method was used to analyze the correlation between physical activity and nutritional status.Results:The first part of the nutrition assessment study was finally included in 1804 patients,the average GNRI value was 92.96±9.15,and the overall distribution was normal.The multivariate Cox risk ratio model found that GNRI can independently predict all-cause death after adjusting for multiple confounding factors(HR=0.96,P<0.001,95%CI:0.95-0.98).The GNRI survival cutoff was 94.55,and the survival rates between two groups were significantly different(P<0.001).Among 309 patients in second part,RAPA score was mainly 3 points(61.4%)and the number of 30"STS were 15.58±4.81.According to the comparisons among the groups,patients' physical performance was better,the Body Mass Index(BMI)was higher,the Geriatric Nutritional Risk Index(GNRI)was higher,the numbers of sit-ups completed were more,and the C-reactive protein(CRP)was lower(p<0.05).With the enhancement of physical fitness,age,Charlson complication score,incidence of peritonitis showed the decreasing trend,and other nutrition related indicators,such as albumin,hemoglobin,daily protein intake per kilogram showed the increasing trend,but no significant statistical difference was found.In Pearman analysis,GNRI was positively correlated with RAPA and 30"STS(r?0.144,P=0.012;r=0.120,P?0.035).Conclusions:The overall physical capacity of the subjects investigated was at a low level,and there was a certain correlation among physical activity,nutritional status and inflammatory indicators,however,whose relationship with prognosis needs to be further studied.These two simple methods can quickly assess the activity ability,and will be used for periodic outpatient evaluation,in order to provide targeted daily activity recommendations and nutritional improvement.