Effect of peritoneal dialysis and hemodialysis on nutritional status and inflammatory response in elderly patients with end-stage renal disease

doi:10.3877/cma.j.issn.1674-0785.2023.04.010

Abstract

Abstract:

Objective

To investigate the effect of peritoneal dialysis (PD) and hemodialysis (HD) on the nutritional status and inflammatory response in elderly patients with end-stage renal disease (ESRD).

Methods

The medical records of 112 patients with ESRD in Huangshan People's Hospital from May 2019 to May 2022 were retrospectively analyzed, and they were divided into either a PD group or an HD group according to the method of dialysis used. The PD group was treated by PD, while the HD group underwent HD therapy. The renal function, inflammatory factors, immune function, nutritional status, and rate of complications before and after treatment were compared between the two groups.

Results

After treatment, the blood urea nitrogen and serum creatinine levels in the both groups were lower than those before treatment (P＜0.05), but no significant difference was found between the groups (P＞0.05). The levels of procalcitonin, hypersensitive C-reactive protein, white blood cell count, and neutrophils in the PD group after treatment were lower than those of the HD group (P＜0.05). After treatment, albumin, hemoglobin, total protein, the percentages of CD4+ T cells and CD3+ T cells, and CD4+/CD8+ ratio in the PD group were higher than those of the HD group, while the percentage of CD8+ T cells was lower than that of the HD group (P＜0.05). The total incidence of complications was 14.04% in the PD group, which showed no significant difference as compared with that in the HD group (18.18%; P＞0.05).

Conclusion

Compared with HD, PD has advantages in reducing the inflammatory reaction, and improving the immune function and nutritional status of elderly patients with ESRD, without increasing the risk of complications.

Key words: End-stage renal disease, Old age, Peritoneal dialysis, Hemodialysis, Nutritional status, Inflammatory reaction

Yunhui Zhang, Jun Luo, Lili Liu, Hong Wang, Keming Geng. Effect of peritoneal dialysis and hemodialysis on nutritional status and inflammatory response in elderly patients with end-stage renal disease[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(04): 419-423.

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Figures/Tables 5

References 20

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组别	例数	BUN（mmol/L）		Scr（μmol/L）
组别	例数	治疗前	治疗后	治疗前	治疗后
PD组	57	23.56±4.03	19.64±2.14^a	772.18±46.15	599.27±32.46^a
HD组	55	23.71±3.97	19.73±2.51^a	768.41±44.55	588.56±37.09^a
t值		0.198	0.204	0.440	1.628
P值		0.843	0.839	0.661	0.106

组别	例数	BUN（mmol/L）		Scr（μmol/L）
组别	例数	治疗前	治疗后	治疗前	治疗后
PD组	57	23.56±4.03	19.64±2.14^a	772.18±46.15	599.27±32.46^a
HD组	55	23.71±3.97	19.73±2.51^a	768.41±44.55	588.56±37.09^a
t值		0.198	0.204	0.440	1.628
P值		0.843	0.839	0.661	0.106

组别	例数	PCT（ng/ml）		hs-CRP（mg/L）		WBC（×10⁹/L）		中性粒细胞数量（×10⁹/L）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
PD组	57	1.89±0.48	0.39±0.11^a	14.38±1.50	8.56±1.12^a	4.57±0.28	4.17±0.10^a	3.45±0.20	3.24±0.08^a
HD组	55	1.85±0.42	0.48±0.12^a	14.47±1.53	9.26±1.20^a	4.61±0.31	4.32±0.14^a	3.50±0.23	3.40±0.12^a
t值		0.469	4.140	0.314	3.193	0.717	6.543	1.229	8.330
P值		0.640	＜0.001	0.754	0.002	0.475	＜0.001	0.222	＜0.001

组别	例数	PCT（ng/ml）		hs-CRP（mg/L）		WBC（×10⁹/L）		中性粒细胞数量（×10⁹/L）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
PD组	57	1.89±0.48	0.39±0.11^a	14.38±1.50	8.56±1.12^a	4.57±0.28	4.17±0.10^a	3.45±0.20	3.24±0.08^a
HD组	55	1.85±0.42	0.48±0.12^a	14.47±1.53	9.26±1.20^a	4.61±0.31	4.32±0.14^a	3.50±0.23	3.40±0.12^a
t值		0.469	4.140	0.314	3.193	0.717	6.543	1.229	8.330
P值		0.640	＜0.001	0.754	0.002	0.475	＜0.001	0.222	＜0.001

组别	例数	Alb		Hb		TP
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
PD组	57	28.46±5.27	34.18±6.14^a	98.58±15.14	111.26±17.64^a	54.27±7.21	60.08±7.83^a
HD组	55	28.30±5.16	28.67±5.29	99.37±14.98	101.50±15.01	55.15±7.29	56.22±7.15
t值		0.162	5.080	0.278	3.148	0.642	2.722
P值		0.872	＜0.001	0.782	0.002	0.522	0.008

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