| Objective: To investigate iron metabolism in patients with continuous ambulate peritoneal dialysis,and to analyze the clinical characteristics of iron metabolism in patients with peritoneal dialysis-associated peritonitis.Methods: A total of 136 patients admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities from October 2021 to January 2023 with regular continuous ambulate peritoneal dialysis and complete medical records were selected.General information,clinical data,iron metabolism indexes(including serum iron,serum ferritin,transferrin saturation,serum total iron binding capacity,hepcidin)were collected.According to SF level and/or TSAT level,the patients were divided into iron deficiency group,iron normal group,high ferritin group and iron overload group.The correlation between clinical data and peritoneal dialysis-associated peritonitis(PDAP)among the four groups was compared,and the risk correlation between iron metabolism index and PDAP was analyzed.The patients were divided into PDAP group and non-PDAP group,and the differences of clinical data(including SI,SF,TSAT,TIBC,and hepcidin)between the two groups were compared,so as to analyze the clinical characteristics of iron metabolism in peritoneal dialysis-associated peritonitis.Results:(1)A total of 136 CAPD patients were enrolled,including 93 patients with non-PDAP and 43 patients with PDAP,including 73 males and 63 females.The mean age was45.5 years,and the mean dialysis duration was 3.01 years.There were 69 cases in iron deficiency group,25 cases in normal iron group,4 cases in hyperferritinemia group,and 38 cases in iron overload group.(2)Serum iron and transferrin saturation,serum ferritin and transferrin saturation were positively correlated(r=0.534,P=0.000;r=0.298,P=0.000),serum ferritin and total iron binding capacity,and total iron binding capacity and transferrin saturation were negatively correlated(r=-0.203,P=0.018;r=-0.658,P=0.000).(3)There were significant differences in serum calcium(P < 0.05)and SI,SF,TIBC and TSAT(P < 0.05)among the four groups of iron deficiency,normal iron,high ferritin and iron overload.(4)In the PDAP group,23 patients were iron deficient,5 patients were iron normal,and 15 patients were iron overload.The age,WBC,CPR,neutrophil count,neutrophil percentage and monocyte percentage in PDAP group were higher than those in non-PDAP group,and the differences were statistically significant(P < 0.05).The albumin,serum calcium,phosphorus,PTH,TC,TG and SCr in PDAP group were lower than those in non-PDAP group,and the differences were statistically significant(P < 0.05).(5)In the PDAP group,SI and TSAT were significantly lower than those in the non-PDAP group,and SF was significantly higher than that in the non-PDAP group(P < 0.05).There was no significant difference in TIBC and hepcidin between the two groups(P > 0.05).(6)Logistic multivariate analysis showed that SI,serum calcium,PTH and TG were independent risk factors for peritonitis in patients(OR=1.162,95%CI: 1.037-1.302;OR=17.941,95%CI: 1.992-161.604;OR=1.002,95%CI:1-1.004;OR=1.802,95%CI: 1.067-3.043).(7)The area under the ROC curve of combining SI,SF,TSAT,TIBC and Hepcidin was about 0.653(95%CI,0.553-0.754),the sensitivity was33.3%,and the specificity was 92.6%.Conclusion:(1)Iron metabolism disorder is common in peritoneal dialysis patients,manifested as iron deficiency or iron overload.(2)The clinical manifestations of iron metabolism in patients with peritoneal dialysation-associated peritonitis were hypoferriemia,hypotransferrin desaturemia combined with high serum ferritin.(3)Decreased serum iron and transferrin saturation and increased ferritin were risk factors for peritoneal dialysis-associated peritonitis,and serum iron decline is an independent risk factor for peritonitis.(4)There was no correlation between total iron binding capacity,hepcidin and peritoneal dialysis-associated peritonitis. |
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