The Study Of Impact Factors Of Volume Load And Thier Relations With Malnutrition And Inflammation On Continuous Ambulatory Peritoneal Dialysis Patients

Objective: This research evaluate volume status on Continuous Ambulatory PeritonealDialysis(CAPD) patients through the multi-frequency bioimpedance analysis, and findout the factors influencing the volume status of CAPD patients. In addition,we evaluatethe relationship between volume status and malnutrition and inflammation.Methods: Sixty CAPD patients were enrolled from Shenyang military region generalhospital nephrology department from2006to2013to carry on the cross-sectional study(35cases of male, female25cases). Thirty cases of healthy people as control groupmatched for age and sex. Multi-frequency bioimpedance analysis was used to evaluatethe patient’s volume status. According to extracellular water(ECW)/total body water(TBW), we divided the patients into volume overload group (ECW/TBW≥0.39), andnormal group (ECW/TBW <0.39). Measure the patient’s blood pressure in themeantime. Blood samples for biochemical measurements were taken such as: serumalbumin, creatinine total protein, and urea nitrogen. C-reactive protein was used topresent the inflammatory marker. Fasting blood collection,24-hour urine volume and24-hour peritoneal dialysis ultrafiltration volume were collect to assess dialysisadequacy and residual renal function of the patients.Results:1. The case group and healthy group comparison: The ECW, TBW,ECW/TBW, ECW/ICW in CAPD patients were higher than healthy controls (p <0.05).But the content of ICW in two groups have no difference (p>0.05).2.60CAPD patients in volume overload group (34cases), ECW, ECW/ICW, systolic blood pressure, age, C-reactive protein is higher than normal group (26cases)while Alb, residual renal function and weekly urea clearance index, weekly creatinineclearance capacity were lower than normal group (p <0.05).3.In malnutrition group (37cases) the ECW/ICW, age, systolic blood pressure, C-reactive protein were higher than normal nutrition group (23cases)(p <0.05).4. In inflammation group (31cases) ECW, ECW/ICW, serum albumin, systolicblood pressure, age, were higher than in unincorporated inflammation group (29cases),while a week creatinine clearance below the unincorporated inflammation group (p <0.05).5. Volume status indicator (ICW) was positively correlated with serum creatinine(Scr), serum urea nitrogen (BUN), and negatively correlated with age, urea clearanceindex (Kt/v).ECW was positively correlated with systolic blood pressure, Scr, BUN,CRP, and negatively correlated with Kt/v, Alb. TBW was positively correlated withsystolic blood pressure, Scr, BUN, CRP, and negatively correlated with age, Kt/v.ECW/TBW was positively correlated with age, systolic blood pressure, CRP, andnegatively correlated with Alb, total protein(TP). ECW/ICW was positively correlatedwith systolic blood pressure, CRP, age, and negatively correlated with Alb, TP.Conclusion:1.60CAPD patients of overload capacity proportion is56.67%,performance characteristics of the increase of ECW, ECW/TBW ratio, ECW/ICW ratio.2. The influence factors of volume overload CAPD patients include: age, SBP,RRF, Kt/v, Ccr, CRP levels.3. CAPD patients of volume overload groups capacity of C-reactive protein ishigher than normal group, while serum albumin is lower than the normal group. Showedthat in the volume overload group malnutrition and inflammation are widespread onCAPD patients.4. Volume status indicators has a strong correlation with nutrition indicators,inflammation, status, age, systolic blood pressure, and Kt/v.