A Low Prognostic Nutritional Index Is a Risk Factor for High Peritoneal Transport Status in Patients Undergoing Peritoneal Dialysis

Yajuan Huang; Xing Zhang; Xingming Tang; Liwen Tang; Sijia Shang; Xiaoyang Wang; Yueqiang Wen; Xiaoran Feng; Qian Zhou; Ning Su; Rui Zhang

doi:10.1053/j.jrn.2022.03.007

A Low Prognostic Nutritional Index Is a Risk Factor for High Peritoneal Transport Status in Patients Undergoing Peritoneal Dialysis

J Ren Nutr. 2023 Jan;33(1):201-207. doi: 10.1053/j.jrn.2022.03.007. Epub 2022 Mar 31.

Authors

Yajuan Huang¹, Xing Zhang¹, Xingming Tang², Liwen Tang², Sijia Shang¹, Xiaoyang Wang³, Yueqiang Wen⁴, Xiaoran Feng⁵, Qian Zhou⁶, Ning Su⁷, Rui Zhang⁸

Affiliations

¹ Department of Nephrology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
² Department of Nephrology, The Affiliated Tung Wah Hospital of Sun Yat-sen University, Dongguan, China.
³ Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, ZhengZhou, China.
⁴ Department of Nephrology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
⁵ Department of Nephrology, Jiujiang First People's Hospital, Jiujiang, China.
⁶ Department of Medical Statistics and Clinical Trials Unit, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁷ Department of Nephrology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: suning5@mail.sysu.edu.cn.
⁸ Department of Nephrology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: zhangr32@mail.sysu.edu.cn.

PMID: 35367359
DOI: 10.1053/j.jrn.2022.03.007

Abstract

Objectives: A high peritoneal transport status is a risk factor for mortality and causes technical failure in patients on peritoneal dialysis (PD). High peritoneal transport status is associated with malnutrition and inflammation in patients with PD. The prognostic nutritional index (PNI) is a marker determined by the serum albumin level and lymphocyte count in the peripheral blood. The aim of this study is to investigate the association between PNI and high peritoneal transport status in patients with PD.

Methods: We retrospectively investigated patients with PD from January 1, 2013 to May 31, 2020, in 4 PD centers. Patients with PD were divided into 2 groups according to PNI quartiles: the low PNI group (PNI ≤ 36.6) and the high PNI group (PNI > 36.6). The demographics and clinical and laboratory baseline data of the 2 groups were collected and compared. The association between PNI and high peritoneal transport status was analyzed by multivariate logistic regression analysis.

Results: A total of 404 patients with PD were enrolled in our study. A total of 77 (19.06%) patients had high peritoneal transport status. After adjusting for age, sex, body mass index, hypertension, diabetes mellitus, residual urine volume, current smoking status, pre-existing cardiovascular disease, hemoglobin, white blood cell count, triglycerides, and intact parathyroid hormone, low PNI levels were significantly associated with high peritoneal transport status (odds ratio 3.42, 95% confidence interval 1.82-5.18, P = .0056). Subgroup analysis showed that there was no interaction among PNI and age, sex, diabetes, body mass index, pre-existing cardiovascular disease, or current smoking.

Conclusion: As a marker for malnutrition and inflammation, a low level of PNI is an independent risk factor for high peritoneal transport status in patients with PD.

Keywords: high peritoneal transport; nutrition; peritoneal dialysis; peritoneal permeability; prognostic nutritional index.

MeSH terms

Cardiovascular Diseases* / complications
Humans
Inflammation / complications
Inflammation / epidemiology
Malnutrition* / complications
Malnutrition* / epidemiology
Nutrition Assessment
Nutritional Status
Peritoneal Dialysis*
Prognosis
Retrospective Studies
Risk Factors