Low Dietary Sodium Intake Increases the Death Risk in Peritoneal Dialysis
Low Dietary Sodium Intake Increases the Death Risk in Peritoneal Dialysis
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DOI：
10.2215/cjn.05410709
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发表时间：
2010-02-01
影响因子：
9.8
通讯作者：
Luo, Jianfeng
中科院分区：
文献类型：
--
作者：
Dong, Jie;Li, Yanjun;Luo, Jianfeng
背景和目的：探讨膳食钠摄入量与心血管疾病和总死亡率的相关性，并确定这种相关性是否可以用透析患者的蛋白质和能量摄入量与钠摄入量平行来解释。设计、背景、参与者和测量：这项单中心回顾性队列研究纳入了从2002年7月至2007年2月在我科开始腹膜透析的305名患者。所有患者都接受了跟踪，直到死亡或在2008年2月接受审查。人口统计数据是在基线上收集的。生化、饮食和营养数据在基线和之后的定期间隔进行检查，以计算整个研究过程中的平均值。结果：平均钠摄入量最高的参与者更有可能是年轻、男性和超重。平均钠摄入量高三分位数的患者白蛋白、前白蛋白和瘦体重水平较高，且与钠摄入量平行的营养摄入量较多。在调整了公认的混杂因素后，低平均钠摄入量独立地预测了总体和心血管死亡风险的增加。进一步调整膳食蛋白质、能量和其他营养素的摄入量对平均钠摄入量与总死亡率和心血管死亡之间的关系影响很小，危险比在0.35~0.44之间，心血管死亡的危险比在0.06~0.11之间。结论：本研究显示低钠摄入量独立地预测了透析患者的高总死亡率和心血管死亡率。这种相关性不能完全用蛋白质和能量摄入不足来解释。Chit J am Soc Neplirol 5：240-247,2010。DOI：10.2215/CJN.05410709
Background and objectives: To explore the correlation between dietary sodium intake and cardiovascular and overall mortality, and then determine whether this correlation can be explained by protein and energy intake paralleled with sodium intake in dialysis patients.Design, setting, participants, & measurements: This single-center retrospective cohort study enrolled 305 incident patients who started peritoneal dialysis in our unit from July 2002 to February 2007. All patients were followed until death or until being censored in February 2008. Demographic data were collected at baseline. Biochemical, dietary, and nutrition data were examined at baseline and thereafter at regular intervals to calculate the average values throughout the study.Results: Participants with the highest average sodium intake were more likely to be younger, male, and overweight. Patients in the high tertile of average sodium intake had higher albumin, prealbumin, and lean body mass levels, and more nutrient intakes paralleling with sodium intake. Low average sodium intake independently predicted the increased risk for overall and cardiovascular death after adjusting for recognized confounders. Further adjustment for dietary protein, energy, and other nutrient intakes individually had minimal impact on the association between average sodium intake and overall death, with hazard ratios varying between 0.35 and 0.44, and cardiovascular death, with hazard ratios varying between 0.06 and 0.11.Conclusions: This study revealed that low dietary sodium intake independently predicts the high overall and cardiovascular mortality in dialysis patients. This correlation could not be entirely explained by deficient protein and energy intake. Chit J Am Soc Neplirol 5: 240-247, 2010. doi: 10.2215/CJN.05410709