Study On The Relationship Between Nutritional Status,Micro-inflammation And Cardiac Valve Calcification Among Patients With Diabetic Kidney Diease On Continuous Ambulatory Peritoneal Dialysis

Objective:To analyze the prevalence of malnutrition in patients treated with continuous ambulatory peritoneal dialysis(CAPD)for end stage diabetic nephropathy(ESDN)and evaluate its correlation between micro-inflammatory status and cardiac valve calcification in the Renal Department.the second affiliated hospital of Kunming Medical University.Methods:According to the standard and exclusion criteria,finally we choose 100 patients who treated with continuous ambulatory peritoneal dialysis for end stage diabetic nephropathy(their dialysis age more than 6 months)in the Renal Department,the second affiliated hospital of Kunming Medical University.Using modified quantitative subjective global assessment(MQSGA)to assess the nutritional status of patients in the group,according to the scores,they are divided into three groups:normal nutrition group,mild to moderate malnutrition group,severe malnutrition group.Collecting their examinations including:nutritional biomakers:hemoglobin,albumin,prealbumin,blood urea nitrogen,serum creatinine;lipid biomakers:total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein;inflammation biomarkers:interleukin-6,high-sensitive C-reactive protein.Comparing their differences between the groups and analysing the correlations between nutrition and inflammation.Collecting electrolyte biomarkers:serum calcium,serum phosphate,intact parathyroid hormone and cardiac valve calcification,comparing their difference between the groupsResults:Total patients participate in this study were 100,34 of which were normal,34 of which were mild to moderate malnutrition and 32 of which were severe malnutrition.1.The serum hemoglobin,albumin and prealbmin,high density lipoprotein triglycerides,interleukin-6,high-sensitive C-reactive protein showed significant differences among the three groups(P<0.05).Compared with the mild to moderate group,the sever malnutrition group,their serum hemoglobin,albumin and prealbmin,high density lipoprotein were significantly decreased,triglycerides interleukin-6,high-sensitive C-reactive protein were significantly increased(P<0.05).Compared with the normal group,the sever malnutrition group,their serum hemoglobin,albumin and prealbmin,high density lipoprotein were significantly decreased,triglycerides,interleukin-6,high-sensitive C-reactive protein were significantly increased(P<0.05).Compared with the normal group,the mild to moderate group,the serum hemoglobin,albumin and prealbmin were significantly decreased,triglycerides interleukin-6,high-sensitive C-reactive protein were significantly increased(P<0.05).The left characters have no difference,including urea nitrogen,serum creatinine,total cholesterol,low density lipoprotein(P>0.05).2.Pearson correlation analysis showed that the serum interleukin-6 and the serum high-sensitive C-reactive protein had negative correlation with the serum hemoglobin,albumin and prealbumin,high density lipoprotein(P<0.05)and no correlation with urea nitrogen,serum creatinine,total cholesterol,triglycerides,low density lipopro-tein(P>0.05).3.The serum phosphate and cardiac valve calcification showed significant differences among the three groups(P<0.05).Compared with the normal group,the sever malnutrition group,their serum phosphate and cardiac valve calcification were significantly increased(P<0.05).And compared with the normal group,the mild to moderate malnutrition group,their serum phosphate and cardiac valve calcification were significantly increased(P<0.05).The left characters have no difference,including serum calcium and intact parathyroid hormone(P>0.05).Conclusion:There are correlations between nutritional status and micro-inflammatory states in patients on continuous ambulatory peritoneal dialysis.The patients who got sever malnutrition,the inflammation index are higher.Malnutrition and micro-inflammation has apparently negative correlation.There are correlations between nutritional status and cardiac valve calcification,the incidence of cardiac valve calcification is high in patients with malnutrition.