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学科主题: 临床医学
题名:
Does loss of residual renal function lead to malnutrition in peritoneal dialysis patients?
作者: Cheng, L. -T.; Chen, W.; Tang, W.; Wang, T.
关键词: residual renal function ; malnutrition ; peritoneal dialysis
刊名: CLINICAL NEPHROLOGY
发表日期: 2006-09-01
卷: 66, 期:3, 页:192-201
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: TUMOR-NECROSIS-FACTOR ; DIETARY-PROTEIN ; CAPD PATIENTS ; CONTROLLED-TRIAL ; FLUID STATUS ; PARAMETERS ; UREA ; CLEARANCES ; SURVIVAL ; ADEQUACY
英文摘要:

Objectives: It is usually believed that loss of residual renal function is associated with anorexia and the development of malnutrition. We conducted a retrospective study in our center to evaluate the effect of declining residual renal function on patients′ nutritional status. Methods: All incident uremic patients (n = 46) who began peritoneal dialysis from January 1, 2003 - June 1, 2003 in our center were closely followed for 1 year with focus on maintaining strict volume control with time on dialysis. Patient′s residual renal function (RRF) was assessed by the average renal urea and creatinine clearances. Those patients who had more than 50% decrease in GFR were selected for the present analysis. Serum albumin (ALB), dietary protein intake (DPI) and subjective global assessment (SGA) were closely followed. Results: There were 16 patients (9 males and 7 females) included in the present analysis, among whom 31.3% were diabetics. Patients′ GFR declined significantly (RRF were 4.32 +/- 2.69, 2.99 +/- 2.21 and 1.24 +/- 0.99 ml/min for Months 1, 6 and 12, respectively, p < 0.05), along with a significant decline in urine volume (985.62 +/- 543.29, 698.13 +/- 463.59 and 425.63 +/- 320.52 ml/d for Months 1, 6 and 12, respectively, p < 0.01). Although weekly peritoneal Kt/V did not increase significantly, peritoneal ultrafiltration increased significantly during this period (428.75 +/- 408.96, 534.38 +/- 296.39, 844.38 +/- 440.35 ml for Months 1, 6 and 12, respectively, p < 0.05). Serum ALB increased significantly (32.34 +/- 5.07, 34.74 +/- 4.89 and 36.21 +/- 3.98 g/l for Months 1, 6 and 12, respectively, p < 0.01). DPI also increased significantly. The prevalence of malnutrition (by SGA) decreased from 62.5% at the start of dialysis to 18.8% at the end of this study (p < 0.05). Conclusions: Our study suggests that rapid decline of residual renal function in PD patients does not necessarily lead to decreased dietary protein intake and deteriorated nutritional status. Focus on incremental peritoneal fluid removal along with the decline in residual renal function and, thus, maintaining volume control may be one of the critical reasons for the success.

语种: 英语
WOS记录号: WOS:000240351300007
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64939
Appears in Collections:北京大学第三临床医学院_肾内科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Div Nephrol, Beijing 100083, Peoples R China
2.Peking Univ, Hosp 1, Div Nephrol, Beijing 100083, Peoples R China

Recommended Citation:
Cheng, L. -T.,Chen, W.,Tang, W.,et al. Does loss of residual renal function lead to malnutrition in peritoneal dialysis patients?[J]. CLINICAL NEPHROLOGY,2006,66(3):192-201.
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