Study On The Relationship Between Protein-energy Wasting And Systemic Immune Inflammation Score In Stage 3-5(non Dialysis) Of Chronic Kidney Disease

Objective:To investigate the relationship between Systematic Inflammation Index(SⅡ) and Protein-energy wasting(PEW)in non-dialysis patients with chronic kidney disease stage 3-5.Methods:A total of 175 CKD3-5 non-dialysis patients admitted to the Department of Nephrology of our hospital from January 2021 to December 2021 were selected according to inclusion and exclusion criteria.The enrolled subjects were divided into group A(no PEW group) and group B(PEW group) according to ISRNM diagnostic criteria.General information of patients(age,height,weight,BMI,and complications) was collected,and routine biochemical indicators(RBC count,hemoglobin,albumin,prealbumin,total cholesterol,triglyceride,low density lipoprotein cholesterinlow-density lipoprotein,urea,and serum creatinine)and anthropometric indicators were detected: Mid arm circumference(MAC),middle arm circumference(MAMC),triceps skin fold thickness(TSF),serum lymphocyte count,neutrophil count and platelet count were measured,and systemic immune inflammation score was calculated.The PEW prevalence rate was calculated according to the PEW diagnostic criteria,and the influence of confounding factors was eliminated by the propensity matching score,and the above indicators were analyzed in the two groups.Non-parametric rank sum test and T test were used for data comparison between the two groups,and Spearman and Pearson methods were used for correlation analysis.Factors with P<0.05 in univariate Logistic regression analysis were included in multivariate Logistic regression analysis to obtain the influencing factors of PEW.ROC analysis curve was used to calculate the predictive value and optimal truncation value of SⅡ for PEW.Results :Among 175 patients,127(72.6%) were non-Pew group and 48(27.4%) were PEW group.After propensity matching,there were statistically significant differences in RBC count(P < 0.05),hemoglobin(P < 0.05),platelets count(P < 0.05),albumin(P<0.05),neutrophil count(P<0.05),lymphocytes count(P<0.05),SⅡ(P<0.05),urea nitrogen(P<0.05),creatinine(P<0.05) and triglyceride(P<0.05) between the two groups.SⅡ(P<0.05),urea nitrogen(P<0.05) and creatinine(P<0.05) were positively correlated with PEW,while albumin(P<0.05),hemoglobin(P<0.05),triglyceride(P<0.05) and body weight(P<0.05) were negatively correlated with PEW(P<0.05).Multivariate logistic regression analysis showed that SⅡ(P<0.05) and albumin(P<0.05) were the influencing factors of PEW.ROC curve showed that SⅡ had a sensitivity of 77.1%,specificity of85.1%,and truncation value of 512 for predicting PEW in non-dialysis patients with stage3-5 chronic kidney disease,that is,the probability of PEW was small when SⅡ was lower than 512.SⅡ predicted that PEW’s area under curve(AUC)was 0.846(95%CI:0.765-0.927).Conclusion:(1)PEW is also very common in CKD3-5 non-dialysis patients;(2)SⅡ was positively correlated with PEW,and SⅡ and albumin levels were the influencing factors for PEW.(3)SⅡ has a high predictive value for the occurrence of PEW,and the occurrence of PEW can be identified early and timely intervention by observing the changes of SⅡ in patients.