摘要
目的探讨基线4 h腹腔引流液与血浆肌酐比值(dialysate to plasma ratio of creatinine at 4h,4hD/Pcr)与维持性腹膜透析(peritoneal dialysis,PD)患者不宁腿综合征(restless leg syndrome,RLS)的关系。方法选取2019年12月1日至2020年6月31日于安徽医科大学第二附属医院住院评估腹膜转运功能和透析充分性且既往规律于我中心随访的PD患者,于该次住院期间采用国际不宁腿综合征研究小组制定的诊断标准对RLS进行筛查,评估PD患者RLS患病率,并根据是否发生RLS分为RLS组(RLS+组)和非RLS组(RLS-组)。所有入组患者均已在PD置管后6个月内评估基础腹膜转运功能。分析基线4hD/Pcr等指标与PD患者RLS之间的关系及基线4hD/Pcr对PD患者发生RLS的预测价值。结果共纳入92例PD患者,RLS患病率为33.7%,以中、重度为主(中度35.48%,重度38.71%)。RLS+组年龄、透析龄、基线4hD/Pcr、铁蛋白高于RLS-组,尿量少于RLS-组,其差异均具有统计学意义(均P<0.05)。多因素Logistic回归分析显示高龄(OR=1.054,95%CI 1.010-1.100,P=0.015)、更少的尿量(OR=0.998,95%CI 0.997-0.999,P=0.005)、高基线4hD/Pcr(OR=1.047,95%CI 1.009-1.086,P=0.014)是PD患者发生RLS的独立危险因素。ROC曲线示基线4hD/Pcr预测PD患者RLS发生风险的灵敏度为90.3%,特异度为45.9%。结论高龄、更少的尿量、高基线4hD/Pcr是PD患者发生RLS的独立危险因素,高基线4hD/Pcr对PD患者发生RLS具有一定诊断和预测价值。
Objective To explore the relationship between the baseline dialysate to plasma creatinine ratio at 4h and restless legs syndrome(RLS)in maintenance peritoneal dialysis(PD)patients.Methods From December 1,2019 to June 31,2020,92 hospitalized PD patients were recruited to assess peritoneal transport function and dialysis adequacy.Regular follow-ups were conducted.During hospitalization,RLS was screened according to the diagnostic criteria of International Restless Legs Syndrome Study Groupand the prevalence of RLS evaluated.They were divided into two groups of RLS(RLS+group)and non-RLS(RLS-group)according to whether or not RLS occurred.All of them were evaluated for basic peritoneal transport function within 6 months after PD catheterization.To relationship was analyzed between baseline dialysate to plasma ratio of creatinine at 4h(4hD/Pcr)and RLS and the predictive value of baseline 4hD/Pcrfor RLS examined.Results The prevalence rate of RLS was 33.7%and moderate-to-severe cases predominated(moderate 35.48%,severe 38.71%).Age,dialysis age,baseline 4hD/Pcr and ferritin of RLS+group were significantly higher than those of RLS-group while urine output was significantly less than that of RLS-group(all P<0.05).Multivariate Logistic regression analysis indicated that advanced age(OR=1.054,95%CI 1.010-1.100,P=0.015),lower urine output(OR=0.998,95%CI 0.997-0.999,P=0.005)and higher baseline 4hD/Pcr(OR=1.047,95%CI 1.009-1.086,P=0.014)were independent risk factors for RLS.Receiver operating characteristic(ROC)curve showed that the sensitivity of baseline 4hD/Pcr for predicting the risk of RLS was 90.3%and the specificity 45.9%in PD patients.Conclusion Advanced age,lower urine output and higher baseline 4hD/Pcrare independent risk factors for RLS in PD patients.And high baseline 4hD/Pcr has some diagnostic and predictive value for RLS in PD patients.
作者
闫奇奇
刘桂凌
郝丽
王德光
李丹丹
Yan Qi-qi;Liu Gui-ling;Hao Li;Wang De-guang;Li Dan-dan(Department of Nephrology,Second Affiliated Hospital,Anhui Medical University,Hefei 230601,China)
出处
《临床肾脏病杂志》
2021年第8期624-629,共6页
Journal Of Clinical Nephrology
基金
安徽省第三批卫生计生适宜技术推广项目(2018-TG04)。
关键词
腹膜透析
腹膜转运功能
不宁腿综合征
Peritoneal dialysis
Peritoneal transport function
Restless legs syndrome
作者简介
通信作者:刘桂凌,Email:guilingliu369@163.com。
