Correlation Analysis Between Peritoneal Transport Function And CKD-MBD In Peritoneal Dialysis Patients

Objective:Discuss the correlation between peritoneal transport function in patients with peritoneal dialysis(PD)and chronic kidney disease--mineral and disorder(CKD-MBD),It provides a new way to delay the occurrence of CKD-MBD,improve the survival rate and quality of life of patients,and provides a new idea for clinical treatment.Methods:A total of 82 patients with chronic renal failure who received peritoneal dialysis treatment in the Department of Nephrology,The First Hospital of Shanxi Medical University from January 1,2021 to January 1,2023 were selected according to the inclusion and exclusion criteria.82 routine peritoneal dialysis treatment of patients with peritoneal equilibrium experiment(peritoneal equilibration test,PET),4 h dialysate creatinine concentration and the ratio of serum creatinine concentration(dialysate/plasm,D/P(Cr),D/P Cr value ≥0.65 was divided into high and high mean transport group(H/A group),D/P Cr value < 0.65 was divided into low and low mean transport group(L/A group).General data of patients were collected,including gender,age,dialysis age,height and weight,and Body Mass Index(BMI)was calculated.Biochemical indexes: blood calcium,blood phosphorus,whole parathyroid hormone,serum alkaline phosphatase,hemoglobin,albumin,triglyceride,cholesterol,blood urea,blood uric acid,blood creatinine;Imaging examination: carotid artery color ultrasound.Blood calcium,blood phosphorus,whole parathyroid hormone,alkaline phosphatase and carotid artery calcification were used as indicators to evaluate CKD-MBD for statistical analysis.Results:1.A total of 82 patients receiving peritoneal dialysis were included in this study.There were 44 cases in the high peritoneal transport group and 38 cases in the low peritoneal transport group.General clinical data such as gender,age,dialysis age and BMI were compared between the two groups,and the difference of dialysis age was statistically significant(P < 0.05).There was no significant difference in gender,age or BMI(P>0.05)。2.Compared with the two groups,the blood calcium(Ca)of the high transport group was lower than that of the low transport group,the difference was statistically significant(P<0.05);The whole parathyroid hormone(iPTH)and alkaline phosphatase(ALP)in high transport group were higher than those in low transport group,and the difference was statistically significant(P<0.05).There was no significant difference in blood phosphorus(P)between the two groups(P > 0.05).3.3.82 carotid artery color ultrasound showed carotid artery calcification in a total of 57 patients,including 36(63%)patients in the high transport group and 21(37%)patients in the low transport group,the difference between the two groups was statistically significant(P < 0.05).4.The peritoneal urea clearance(Kt/V)and intraperitoneal creatinine clearance(Ccr)of the high transport group were higher than those of the low transport group,and the difference was statistically significant(P < 0.05).There were no significant differences in hemoglobin,albumin,creatinine,uric acid,urea,triglyceride,cholesterol,Kt/V of residual kidney,Ccr of residual kidney,total Kt/V and total Ccr between the two groups(P > 0.05).5.Correlation analysis: D/P value was positively correlated with peritoneal Kt/V,peritoneal Ccr and dialysis age(P < 0.05).There was no correlation between D/P and other indexes(P > 0.05).Multiple linear regression analysis showed that peritoneal Kt/V,peritoneal Ccr and dialysis age were independent correlation factors for D/P(P < 0.05).Conclusion:The severity of CKD-MBD in peritoneal dialysis patients was higher in the high transport group than in the low transport group.For patients with poor small-molecule toxin transport function,the peritoneal hypertransport state can be properly maintained.In patients with severe CKD-MBD,peritoneal hypotransport can be appropriately maintained.