Research Of The Micro-inflammation Status And Dialysis Adequacy In Peritoneal Dialysis Patients

Objective:The micro-inflammation status exists in the body of ESRD patients and dialysis patients is closely related to the malnutrition, cardiovascular complications. In this article, by detecting of inflammatory factor activation level in the body of peritoneal dialysis patients, and related index adequacy and evaluation of peritoneal dialysis for correlation to observe the role of inflammatory factors in evaluation of peritoneal dialysis adequacy.Methods:Collecting clinical indicators (HB、TP、ALB、Pre-alb’Scr、BUN、TC、Ca、 P、Hs-CRP、CysC, etc.) in the health control group for17, CKD5without dialysis group for20and peritoneal dialysis patients for47,and detecting the content of IL-6, TNF-a in these groups by the method of ELISA. According to healthy controls and peritoneal dialysis group, CKD5without dialysis group and peritoneal dialysis for each group in different age of dialysis (for3months group,6months group and12months group), Hs-CRP(Hs-CRP≤3mg/L group and Hs-CRP>3mg/Lgroup), KT/V(KT/V<1.7group、1.7≤KT/V≤2.0group and KT/V>2.0group) and NLR(NLR≤3.5group and NLR>3.5group) in different levels for grouping, to compare whether there is the difference between the index which represents dialysis adequacy in each group or not. Scoring SGA to47peritoneal dialysis patients.Results:1, The PD group compared with healthy controls, HB, TP, ALB, Pre-alb, Ca levels were decreased significantly, there is the meaning of statistical significance for the difference between both of them. Scr, BUN, CysC, TC, P, calcium-phosphorus product were increased significantly, there is also the meaning of statistical significance for the difference between both of them. Hs-CRP, IL-6, TNF-α levels of peritoneal dialysis group were significantly higher than that of normal control group. P value is less than0.05and there were significant differences between the two groups.2, Scoring SGA to47patients, including the<7.5well-nourished for4(8.5%),7.5-15points, mild to moderate malnutrition has41(87.2%),>15points, severe malnutrition has two (4.3%).3The quantity of Hb in dialysis group for3months and12months period increased significantly than group CKD5. The level of ALB in dialysis for3months group was lower than those of the rest three groups, the rest of three groups have no obvious difference. BUN in dialysis group for3months and6months decreased obviously than CKD5group, dialysis group for12months has been changed a little. The level of Ca in dialysis for6months and12months increased significantly than the CKD5group. The levels of P in dialysis group for3months,6months and12months period decreased obviously than CKD5group. The calcium-phosphorus product in dialysis group for3months and6months decreased obviously than the CKD5group, and dialysis for12months group and CKD5group have no obvious difference. The levels of Hs-CRP in dialysis for6months and12months reduced significantly when they are compared with CKD5group and dialysis for3months group. Content of TNF-a dialysis for3months group higher than the rest of three groups,12months dialysis group were lower than the rest of three groups.4, To compare the Hs-CRP<3mg/L group with the Hs-CRP>3mg/L group,ALB and Pre-alb level are significantly higher than the latter. The Scr levels of Hs-CRP<3mg/L group is higher than the Hs-CRP>3mg/L group. There is no statistical significant difference for the rest of indicators between the two groups.5, The level of Pre-alb in KT/V<1.7group was obviously higher than that in1.7<KT/V≤<2.0group and KT/V>2.0group. The level of Scr in1.7≤KT/V≤2.0group and KT/V>2.0group were lower than in KT/V<1.7group, of which the levels of Scr in KT/V>2.0group is lower than in1.7<KT/V<2.0group. BUN level in KT/V>2.0group was obviously less than in KT/V<1.7group and1.7<KT/V<2.0group. The TC level, KT/V>2.0group is higher than1.7<KT/V<2.0group. There is no significant difference for the rest of indicators among three groups. The level of Ccr in group1.7<KT/V<2.0group and KT/V>2.0are obviously higher than which in KT/V<1.7group.6, To compare the NLR≤3.5group with NLR>3.5group, there is no obvious difference for content of Hs CRP,IL-6, TNF-a.7, The content of Hs-CRP and IL-6are positively correlated. The levels of IL-6also are positively correlated with the content of TNF-a.Hs-CRP negatively correlated with ALB,Pre-alb, Ca, the product of calcium-phosphorus.The rest of the indicators and the Hs-CRP has no obvious correlation. IL-6negatively correlated with P, the product of calcium-phosphorus, and it is not related to the rest of the indicators. While the TNF alpha is not related with any of the clinical indicators.Conclusion:1, The micro-inflammatory status exists in the body of peritoneal dialysis patients.2, Malnutrition is prevalent in peritoneal dialysis patients, for which has a certain correlation between malnutrition and inflammatory factors.3, KT/V and Ccr are the reliable indicators which can be monitored the eliminating of toxinum, but it can’t be judged dialysis adequacy only by the value of KT/V and Ccr,it should be made a comprehensive evaluation base on the patients’ nutriture and micro-inflammation status.