Analysis Of Malnutrition And Related Factors In Patients With Maintenance Hemodialysis

Objective: To analyze the related factors of the occurrence of malnutrition in patients with maintenance hemodialysis and to analyze the comprehensive evaluation of nutritional status of maintenance hemodialysis patients.To explore the relationship between the nutritional status of the patients and related indicators and to provide a theoretical basis for clinical choosing the best therapeutic scheme and specific nursing.Methods: Clinical data of 160 cases of patients with maintenance hemodialysis in our hospital in January 2010 to December 2014 was collected,using subjective global assessment(MQSGA)for all patients to evaluate the nutritional status.Relative index of all patients were tested immediately after dialysis,including:(1)the related factors of malnutrition: dialysis frequency,dietary status,in vivo validation status,gastrointestinal complications,cardiovascular complications,age,gender,dialysis effect,et al.(2)The serological detection index: hemoglobin(HB),C-reactive protein(CRP),albumin(Alb),serum creatinine(SCr),blood urea nitrogen(BUN),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),calcitoninfibrinogen(PCT),PA(precursor protein),blood parathyroid hormone(PTH),serum ferritin(SF)etc.(3)The body measurement index: body mass index(BMI),biceps skinfold thickness(BSF)and triceps skinfold thickness(TSF)etc.Results: The MQSGA evaluation method on 160 cases of maintenance hemodialysis patients to evaluate the nutritional status of the,which is lower than 10 patients for 108 cases,accounting for 67.50%;11to 17 points 35 patients,accounting for 21.88%;18 to 24 points and 15 patients with,9.38%;25to31 points 1 patients,accounting for 0.62%;32to 35 points 1 patients,accounting for 0.62%.Will score for more than 10 points of patients classified as malnourished,accounting for a total of 32.50%.The incidence of malnutrition in the elderly group was 53.85%(35/65);incidence of malnutrition in young group was 18.95%(18/95),the two groups had significant difference(P < 0.05).The incidence of malnutrition in non high protein diet group of patients was 60.71%(34/56),which in the high protein diet group was 18.27%(19/104),with significant differences between the two groups(P < 0.05).The incidence of malnutrition in the blood dialysis sufficiency group was 23.85%(26/109),which in the blood dialysis insufficiency group was 52.94%(27/51),with significant differences between the two groups(P < 0.05).To compare al nutrient l indicators between the normal group and malnutrition group,the age,MAC,MAMC,PAB,Hb,nPCR,Scr and P before hemodialysis of the two groups had significant difference(P < 0.05);the Spearman analysis showed that MQSGA had a significant correlation with age,BMI,MAC,MAMC,ALB,PAB and Hb(P < 0.05).The correlation analysis between the adverse occurrence correlation factors and nutritional index in the maintenance hemodialysis patients showed that,DNPI had a significant positive correlation(P < 0.05)with BUN,PAB,TG,Hb,Scr and nPCR;there was a negative correlation between CRP and ALB,PAB,Hb,nPCR,with a significant positive correlation with Scr;there was a significant negative correlation between PCT and ALB,PAB,Hb,with a significant positive correlation with MAMC,Scr(P < 0.05);there was a significant positive correlation between Kt/V and MAMC,MAC,ALB,PAB,nPCR,with a significant negative correlation between PTH and MAMC,MAC,ALB,PAB,Hb,nPCR;Kru had a significantly positive correlation with MAMC,MAC,ALB,PAB,Hb,nPCR(P < 0.05).Conclusion:1.MQSGA can be used as an effective means to assess nutritional status of maintenance hemodialysis patients,when it combined with DPI,HB,ALB,TC,TG and MAMC,BSF and TSF can be better reflect the nutritional status of the patients.2.The adequacy of hemodialysis has a significant impact on the nutritional status of the patients,PCT and CRP can affect the nutritional status of the patients,and the change of PCT is more sensitive than CRP on nutritional status evaluation.