Investigate The Influence Of Different Peritoneal Transport Type On Nutrition Status，inflammation And Cardiovascular Complications In Peritoneal Dialysis Patients

Objective:To investigate the influence of different peritoneal transport type on Nutrition status,Inflammation andCardiovascular complications in Peritoneal Dialysis patients.Method:1.101patients treated with peritoneal dialysis for at least3months were included in this research.2. Collecting the general information of patients, including age, gender, protopathy, height, weight, bodymass index, hand grip test, surface area, blood pressure, pulse pressure, direct anthropometry,high-sensitivity C-reactive protein, hemoglobin and other biochemistry data.3. According to Twardowski Standard PET to evaluate the peritoneal solute transport characteristics,101CAPD patients divide into4groups: group A (high transport), group B (high average transport),group C (low average transport) and group D (low transport).4. Patients’ nutritional status was evaluated by SGA, serum albumin and so on.5. Patient’s residual renal function was assessed by MDRD formula.6. According to the past history of disease, combined with auxiliary examination (ECG, chest x-rays,echocardiogram, brain CT, MRI, coronary angiography, peripheral vascular Doppler ultrasound, etc.),to determine whether with heart failure, coronary heart disease, left ventricular hypertrophy,arrhythmia, sudden death, cerebral infarction and peripheral vascular disease, etc.Results:1. Among the101patients,8patients (7.9%) were groupA(high transport),43patients (42.6%) were group B (high average transport),40patients (39.6%) were group C (low averagetransport) and10patients (9.9%) were group D (low transport).2. The relationship between peritoneal transport type and nutrition①According to the SGA evaluation results, the4groups of patients with malnutrition incidence hassignificant difference（P=0.003）. There were three patients have good nutrition （37.5%） andfive patients have mild-moderate malnutrition（62.5%）in group A. There were eighteenpatients have good nutrition （41.9%） and twenty-five patients have mild-moderatemalnutrition（58.1%）in group B. There were twenty-six patients have good nutrition（65%）and fourteen patients have mild-moderate malnutrition（35%）in group C. All patients havegood nutrition（100%）in group D. The nutrition status of group D (low transport) is the bestand group A (high transport) is the worst.②Compared with group B, the albumin level has significant high in group C and group D（P=0.009VS P=0.023）.③Peritoneal transport type and SGAscore (R=-0.348, P=0.000)、plasma albumin (R=-0.296,P=0.003), biceps skinfold (R=-0.329,P=0.001), Triceps Skinfold (R=-0.217, P=0.030) have anegative correlation. Peritoneal transport type and left hand grip（R=0.276, P=0.005）, righthand grip（R=0.256, P=0.01）have a positive correlation.3. The relationship between peritoneal transport type and inflammation①Compared with group C, The high-sensitivity C-reactive protein level has significant highin group A（P=0.020）and group B（P=0.021）.②There is a positive correlation between peritoneal transport type and high-sensitivityc-reactive protein（R=0.312, P=0.002）.4. The relationship of peritoneal transport type and cardiovascular complications①The incidence of cardiovascular complications in group A, B, C, D are62.50%,55.81%,47.5%,30%respectively. Compared with group D, the incidence of cardiovascularcomplications have significant high in group A（P=0.020）and group B（P=0.014）. The incidence of cardiovascular complications in group D is the lowest and in group A is thehighest.②Peritoneal transport types and cardiovascular complications has a positive correlation（R=0.268，P=0.000）.5. There was a positive correlation between pulse pressure and cardiovascular complications（R=0.226, P=0.023）. while negative correlation between left hand grip（R=-0.387，P=0.000）, right hand grip（R=-0.365，P=0.000）and cardiovascular complications.Conclusion:1. In our study, the majority CAPD patient’s peritoneal transport types were high averagetransport and low average transport. The nutrition status of low transport is the best and hightransport is the worst. The level of inflammation in low transport is the lowest and in hightransport is the highest. The incidence of cardiovascular complications in low transport is thelowest and in high transport is the highest.2. The relationship between peritoneal transport type and nutrition is negative, and therelationship between peritoneal transport type and inflammation, cardiovascularcomplications were positive.3. Pulse pressure and cardiovascular complications has a negative correlation;. And there isa negative correlation among left hand grip, right hand grip and cardiovascularcomplications.4. High peritoneal transport status and poor nutritional status prone to MIA syndrome.