A comparative study of protein energy wasting patients on maintenance hemodialysis with or without diabetic kidney disease / 国际生物医学工程杂志

ABSTRACT

Objective To analyze the differences of nutritional parameters and body composition in the protein energy wasting (PEW) patients on maintenance hemodialysis with or without diabetic kidney disease (DKD).Methods The patients with PEW were screened by subjective global assessment (SGA) from patients on maintenance hemodialysis from March 2014 to June 2015 in the Fourth Central Hospital of Tianjin.Anthropometric and nutritional parameters were collected before dialysis, and body composition and energy expenditure were examined by the bioelectrica] impedance method.The indexes of the two groups were compared.Results A total of 301 patients on maintenance hemodialysis (DKD 112, non-DKD 189), whose average age was (63.05±14.42) years old, were screened.Among which, 75 patients were diagnosed with PEW, and the overall prevalence rate was 24.92％, including 41 DKD cases with the prevalence of 36.61％ (41/112) and 34 non-DKD cases with the prevalence of 17.99％ (34/189).Compared with uon-PEW patients, the body mass index (BMI), hemoglobin (Hb), albumin (ALB), and total cholestero (TC) of patients with PEW were significantly lower, and C-reactive protein (CRP) were significantly higher (P＜0.05).In the DKD group, the average age of PEW onset ((59.61±13.74) years old), the maintenance dialysis time before PEW ((64± 12.50) months), ALB ((31.34±3.32) g/L), and TC ((4.17±0.95) mol/L) were all lower than those in the non-DKD group ((70.68±14.05) years old, (116.61 ±32.85) months, (32.34±4.64) g/L, (4.95±1.52) mol/L) (P＜ 0.05), respectively.The body composition results showed that muscle mass in the DKD group ((24.84±3.36) kg/ (45.32±6.95)％) was less than that of the non-DKD group ((28.53±3.75) kg/(50.67±7.28)％) (P＜0.05).Conclusions This study indicates that compared with non-DKD dialysis patients, the prevalence of PEW in dialysis patients with DKD is higher, onset age of PEW is younger, the duration of dialysis is shorter, and the muscle consumption is more obvious.