Analysis Of Nutritional Status Of Peritoneal Dialysis And Hemodialysis In The Same Period And Its Impact On Long-term Survival And Prognosis

Objective:To explore the analysis of nutritional factors related to peritoneal dialysis and hemodialysis and the effect on long-term survival prognosis of patients.Methods: The dialysis patients diagnosed and regularly followed up in Anhui Provincial Hospital from 2015 to 2016 were selected.They were divided into peritoneal dialysis group and hemodialysis group,of which peritoneal dialysis group(74 cases)and hemodialysis group(83 cases)The follow-up period was 3 years.The data collection included general information,subjective global assessment(SGA),dietary records and analysis,body measurements,and biochemical indicators.The follow-up deadline was December 2019,and outcomes such as survival,withdrawal from dialysis,or death were recorded.The Cox regression model analyzes the effects of different nutritional indicators on the prognosis,and the ROC curve analyzes the effects of various factors in predicting death.Results: Three years later,157 dialysis patients,of which 8 of 83 hemodialysis patients were converted to kidney transplantation,23 died,a total of 31(37.8%)withdrew from hemodialysis,8 of 74 peritoneal dialysis patients were converted to kidney transplantation,12 to hemodialysis,15 died,and 35(47.3%)withdrew from peritoneal dialysis.Subjective nutritional assessment SGA score The survival rate of the hemodialysis group was significantly higher than that of the peritoneal dialysis group(P=0.000),and SGA,dietary protein intake,serum albumin,cholesterol and body massindex were independent risk factors affecting the prognosis.(1)There were no significant differences in gender,dialysis time,initial dialysis body mass index and the composition of primary disease between the two groups(P > 0.05).(2)There were significant differences in ALB,PALB,CHOL,TG,MAMC and SGA between the two groups(P < 0.05).There were no significant differences in creatinine,urea nitrogen and TSF between the two groups(P > 0.05).Conclusion:1.The study of patients who have long been treated with dialysis as renal replacement therapy found that the nutritional status of hemodialysis patients was better than that of peritoneal dialysis patients in the same period.And the disorder of lipid metabolism was more serious in the peritoneal dialysis group than in the hemodialysis group.2.Elderly age,diabetic nephropathy as the primary disease,SGA,dietary protein intake,ALB,cholesterol and body mass index are independent risk factors affecting the prognosis of hemodialysis.Elevated uric acid and low-density lipoprotein are independent risk factors for cardiovascular adverse events in peritoneal dialysis patients.Controlling blood pressure,lipid level and disturbance of calcium and phosphorus metabolism in dialysis patients are beneficial to prevent cardiovascular adverse events.3.Nutritional status(SGA,ALB,HB),peritoneal dialysis adequacy(Kt/V),residual renal function,advanced age,and plasma albumin 35 g/L are all related factors affecting the quality of life of peritoneal dialysis patients,among which SGA score and Kt/V are the main factors affecting the quality of life of peritoneal dialysis patients.