Influencing Factors Of Malnutrition In Continuous Ambulatory Peritoneal Dialysis Patients

Objective:To study the influencing factors of nutritional status in patients with continuous ambulatory peritoneal dialysis(CAPD).Methods:From June 2019 to April 2022,medical records and laboratory examination was collected from 169 patients.The nutritional status was assessed,and the patients were divided into a nutritionally normal group and a malnutrition group.General profiles,laboratory parameters and nutrition status of two groups were compared,and the correlation between each variable and malnutrition was analyzed,and a multivariate logistic regression analysis was performed.Results:This study includes 169 patients with continuous ambulatory peritoneal dialysis.They include 83 male patients(49.11%)and 86 female patients(50.89%).The age of these patients is 18～80 years old,and the average age is(50.54± 0.94)years.The dialysis age is 3～180 months,with an average of(35.65± 2.80)months.Actual weight 37～93kg,average(60.94±0.19)kg,education level: illiterate(n=32,18.9%),primary school(n=38,22.5%),junior high school(n=61,36.1%),high school(n=24,14.2%),high school or above(n=14,8.3%),primary diseases include: chronic glomerulonephritis(n=114,67.4%),diabetic nephropathy(n=14,8.3%),hypertensive kidney(n= 30,17.8%),polycystic kidney(n=9,5.3%),other(n=2,1.2%).The geriatric nutritional risk index score of 169 patients with CAPD was 91.49 ± 0.50,of which 25 patients had no nutritional risk(14.8%),51 patients had low nutritional risk(30.2%),81 patients had moderate nutritional risk(47.9%),and 12 patients had high nutritional risk(7.1%).According to the GNRI cut-off value of 91.2,86 patients(50.9%)in the malnutrition group and 83 patients(49.1%)in normal nutrition group were divided.There were significant differences in age(P<0.001),diastolic blood pressure(P=0.011),serum albumin(P<0.001),hemoglobin(P=0.047),bicarbonate(P<0.001),uric acid(P=0.038),C-reactive protein(P=0.002),transferrin saturation levels(P<0.001)and prognostic nutritional index(P<0.001)between the two groups(P<0.05).Logistic regression analysis showed that age was an independent risk factor for malnutrition in patients(P<0.05),and serum albumin,bicarbonate and uric acid were protective factors for malnutrition in patients(P<0.05).Conclusion:(1)The incidence of malnutrition in PD patients was 50.9%;(2)The occurrence of malnutrition in PD patients is related to age,diastolic blood pressure,CRP,albumin,hemoglobin,bicarbonate,uric acid and transferrin saturation;(3)Age,albumin,bicarbonate and uric acid are independent related factors of malnutrition in CAPD patients.Among them,age is an independent risk factor that affects the nutritional status of PD patients,and albumin level,bicarbonate level and uric acid level are independent protective factors that affect the nutritional status of PD patients.