Traditional Chinese Medicine Syndromes and Influencing Factors of Protein Energy Wasting in Chronic Kidney Disease Patients Undergoing Maintenance Hemodialysis：a Cross-sectional Study
10.13288/j.11-2166/r.2023.23.009
- VernacularTitle:慢性肾脏病维持性血液透析蛋白质能量消耗患者中医证型及临床影响因素分析
- Author:
Lifen XIE
1
;
Lili ZHANG
1
;
Qin LUO
1
;
Mengni WU
1
;
Linsen QIN
1
;
Qiaoying ZHANG
1
;
Jieying QI
1
;
Haiyu GUAN
1
;
Xiaoli NIE
1
Author Information
1. Integrated Hospital of Traditional Chinese Medicine，Southern Medical University， Guangzhou， 510315
- Publication Type:Journal Article
- Keywords:
chronic kidney disease;
maintenance hemodialysis;
protein-energy wasting;
traditional Chinese medicine syndromes;
influencing factors
- From:
Journal of Traditional Chinese Medicine
2023;64(23):2419-2426
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome types and influencing factors of protein-energy wasting （PEW） in chronic kidney disease （CKD） undergoing maintenance hemodialysis （MHD）. MethodsAccording to diagnostic criteria， 164 patients with MHD were divided into PEW group and non-PEW group. The clinical data of all patients were collected， including general information such as gender， age， height and weight， disease characteristics such as course， cormobidity， and haemodialysis duration， laboratory indicators such as blood routine， liver function， renal function， electrolyte， blood lipid， grip strength， and the four examinations. Logistic regression analysis was used to find the influencing factors of PEW by taking the clinical indicators with significant differences between the two groups （P＜0.05） as the independent variables， diagnosis of PEW as the dependent variable， and normal values as the reference. ResultsOut of 164 patients with MHD， there were 96 （58.5%） cases in PEW group and 68 cases （41.5%） in non-PEW group. Compared to the non-PEW group，PEW group had increased age， ratios of bedrest， deep vein preservation， edema， and low grip strength， percentages of comorbidities type 2 diabetes， cardiovascular and cerebrovascular diseases，infections and anemia， and levels of alanine aminotransferase and permine amin aminotransferase， as well as decreased body mass index， self-care ratio，internal arteriovenous fistula， red blood cell count， hemoglobin， serum total protein， serum albumin levels （P＜0.05）. The PEW group had significantly higher frequency of poor appetite and digestion， abdominal distension， fear of cold and preference of warmth， weak breathing and fatigue， poor appetite， oliguria， nausea and vomiting than non-PEW group （P＜0.05）. The incidence of both yin and yang deficiency syndrome and damp-turbidity syndrome were significantly higher in the PEW group than the non-PEW group， while that of liver-kidney yin deficiency syndrome and stirring of wind syndrome were lower （P＜0.05）. Logistic regression analysis showed that low BMI （＜22 kg/m2）， inability to take care of oneself， low grip strength，low serum albumin （＜38 g/L）， infection， older age， fear of cold and cold limbs，and poor appetite were the risk factors of PEW in patients undergoing MHD （P＜0.05）. ConclusionThe root syndrome of MHD-PEW patients is both yin and yang deficiency， concurrent with damp-turbidity syndrome. Low BMI， low serum albumin， infection and older age may be the influencing factors of PEW in patients undergoing MHD.
