The Association Of Systemic Immune-inflammation Index With Protein-energy Wasting In Peritoneal Dialysis Patients

Objective:To explore the association of systemic immune-inflammation index(SII)with protein-energy wasting(PEW)in continuous ambulatory peritoneal dialysis patients.Methods: Retrospective analysis of 137 patients with continuous ambulant peritoneal dialysis from September 2021 in the Department of Nephrology of the First Affiliated Hospital of Xinjiang Medical University from September 2021 to June 2022,According to the protein-energy wasting(PEW),PEW(n =55)and non-PEW(n =82),Systemic immune-inflammation index and red blood cell distribution width,white blood cell count,interleukin-6,C reactive protein,albumin,pro-albumin,serum creatinine,serum urea nitrogen,triglyceride,total cholesterol,high-density lipoprotein,Differences in indicators such as LDL,To investigate the correlation of the systemic immune-inflammation index with each index,The indicator of statistically significant differences between the two groups,Included in the multivariate Logistic regression analysis,To explore the associated risk factors for developing protein-energy wasting in peritoneal dialysis patients,The predictive value and optimal cut-off value of the systemic immune-inflammation index(SII)for PEW were calculated using the ROC curve.Results: The incidence of protein-energy wasting in this study was 40.1%.Compared with the non-PEW group,the PEW group had higher SII and statistically significant difference(P <0.001);the red cell distribution width,interleukin-6,C-reactive protein,and white cell count were higher in the PEW group than the non-PEW group(all P <0.05);and SII was higher in patients with left ventricular hypertrophy in the PEW group compared with left ventricular hypertrophy in the non-PEW group,statistically significant difference(P <0.001);albumin,hemoglobin,serum creatinine,serum urea nitrogen,and triglyceride were lower than the non-PEW group,the difference was statistically significant(P <0.05).SII was positively correlated with red blood cell distribution width,white blood cell count,interleukin-6,and C-reactive protein,and the difference was statistically significant(all P <0.05),and negative correlation with albumin,BMI,upper arm circumference,statistically significant differences,(P <0.01).The multivariate Logistic regression analysis showed that SII and albumin were the influencing factors for the occurrence of PEW(P <0.05).The results of ROC curve analysis showed that SII has some predictive value for the occurrence of PEW in peritoneal dialysis patients,the area under the PEW curve(AUC)is 0.883,(95%CI:0.826,0.941),with sensitivity(81.8%),specificity(82.9%)and cut-off value(810.08),and the probability of PEW when SII is lower than 810.08 is relatively small.Conclusion:(1)The incidence of protein-energy wasting is high in patients undergoing peritoneal dialysis.(2)SII and albumin levels are the influencing factors of protein-energy wasting in peritoneal dialysis patients.(3)SII may increase when protein-energy wasting occurs in peritoneal dialysis patients,and SII may has some predictive value for the occurrence of protein-energy wasting in peritoneal dialysis patients.