Investigation and interventionable risk factors analysis of protein energy wasting status in maintenance hemodialysis patients by patient-generated subjective global assessment
CHEN Xue-xun1 ZHU Zi-hao2 LIU Zhi-min3 ZHANG Cheng-yin4 ZHANG Hai-bo5 ZHAO Xue-lan1 Xu Hui-yin1 #br#
LI Xuan1 CAO Bo1 CHAI Chun-xiang1 GUO min1 WU Wen-bin4▲
1.Department of Nephrology,Affiliated Hospital of Weifang Medical University,Shandong Province,Weifang 261000,China;
2.Graduate School of Clinical Medical College,Weifang Medical University,Shandong Province,Weifang 261000,China;
3.Department of Nephrology,Weicheng Economic Development Zone Hospital of Weifang,Shandong Province,Weifang 261000,China;
4.Department of Nephrology,Weifang Yidu Central Hospital,Shandong Province,Qingzhou 262500,China;
5.Department of Nephrology,People′s Hospital of Xiashan Ecological and Economic Development Zone of Weifang City,Shandong Province,Weifang 261000,China
Abstract：Objective To investigate the protein energy wasting(PEW)status of patients with maintenance hemodialysis(MHD)by patient-generated subjective global assessment(PG-SGA)and analyze the interventionable risk factors.Methods From September to December 2018,432 patients with MHD were selected as research objects from four dialysis centers of Affiliated Hospital of Weifang Medical University,Weifang Yidu Central Hospital,Weicheng Economic Development Zone Hospital,People′s Hospital of Xiashan Ecological and Economic Development Zone of Weifang City.A cross-sectional study was conducted.The PG-SGA combined with questionnaires,anthropometry and biochemical indicators were used to evaluate PEW status and analyze influencing factors in MHD patients.Results The total incidence rate of PEW in 432 patients with MHD was 52.78%.The total incidence rates of PEW in patients with diabetes,acidosis,inadequate dialysis Kt/V＜1.2,age≥65 years,and dialysis time≥5 years were higher than those in non-diabetes,non-acidosis,adequate dialysis,age＜65 years,and dialysis time＜5 years patients,the differences were statistically significant(P＜0.05).In different PG-SGA qualitative evaluation,individual nutritional indicators such as bodymass index(BMI),upper arm midpoint circumference(MAC),triceps skin fold thickness(TSF),upper arm muscle circumference(MAMC),albumin(ALB),and hemoglobin(Hb),PG-SGA C was lower than PG-SGA A and PG-SGA B,and PG-SGA B was lower than PG-SGA A,with statistically significant differences(P＜0.05).Logistic multivariate analysis showed that diabetes(OR=3.01,95%CI:1.52-5.84),acidosis(OR=1.92,95%CI:1.13-3.34),inadequate dialysis Kt/V＜1.2(OR=1.73,95%CI:1.05-3.68)were all interventionable risk factors for PEW in MHD patients(P＜0.05).Conclusion The incidence of PEW is high in MHD patients,especially in patients with diabetes.Diabetes,acidosis and inadequate dialysis Kt/V＜1.2 are interventionable risk factors for PEW in MHD patients.
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