PNI hemodialysis PLOS one data.xlsx

<b>Background:</b> End-stage renal disease (ESRD) patients frequently experience protein-energy wasting (PEW), which increases their morbidity and mortality rates.<b>Objective:</b> This study explores the effects of nutritional status and pulmonary function on the short- and long-term mortality of ESRD patients undergoing hemodialysis.<b>Materials and Methods:</b> 67 consecutive ESRD patients on maintenance hemodialysis were included in the study. The primary outcomes were all-cause one-year and five-year mortality. Data on demographic characteristics, comorbidities, and laboratory findings were collected. Pulmonary function tests were conducted along with body composition measurements using bioelectrical impedance analysis (BIA). Malnutrition was assessed using the Prognostic Nutritional Index (PNI).<b>Results:</b> The median age of the patients was 60.9 ± 12.4 years, with 58.3% being male. Pulmonary function parameters (FEV1 and FVC) were significantly associated with short-term mortality. The PNI was a significant predictor of both short-term and long-term mortality. A PNI score ≤ 39.01 was associated with increased short-term mortality (HR: 0.65, 95% CI: 0.48-0.88, p = 0.006), while a score ≤ 40 was linked to increased long-term mortality (HR: 0.80, 95% CI: 0.67-0.95, p = 0.015). Additionally, older age (HR: 1.06, 95% CI: 1.01-1.12, p = 0.021) and higher glomerular filtration rate (GFR) (HR: 1.23, 95% CI: 1.02-1.42, p = 0.024) were related to increased long-term mortality risk.<b>Conclusion:</b> The study demonstrates that PNI, age, and pulmonary function are critical factors influencing the survival of hemodialysis patients. These findings underscore the importance of comprehensive nutritional and pulmonary assessment to improve clinical outcomes in this population.

<b>背景：</b>终末期肾病（End-stage renal disease, ESRD）患者常出现蛋白质能量消耗（protein-energy wasting, PEW），该病症会升高患者的发病率与死亡率。<b>研究目的：</b>本研究旨在探讨营养状况与肺功能对维持性血液透析终末期肾病患者短期及长期死亡率的影响。<b>材料与方法：</b>本研究纳入67例连续性维持性血液透析终末期肾病患者。主要结局指标为全因一年死亡率与全因五年死亡率。研究收集了患者的人口统计学特征、合并症及实验室检查相关数据。同时开展肺功能检测，并采用生物电阻抗分析法（bioelectrical impedance analysis, BIA）进行身体成分测量。采用预后营养指数（Prognostic Nutritional Index, PNI）评估营养不良状况。<b>研究结果：</b>患者的中位年龄为60.9±12.4岁，其中男性占比58.3%。肺功能参数（第一秒用力呼气容积FEV1、用力肺活量FVC）与短期死亡率显著相关。预后营养指数（PNI）是短期及长期死亡率的显著预测因子：PNI评分≤39.01与短期死亡率升高相关（风险比（Hazard Ratio, HR）：0.65，95%置信区间（Confidence Interval, CI）：0.48-0.88，p=0.006），而PNI评分≤40则与长期死亡率升高相关（HR：0.80，95%CI：0.67-0.95，p=0.015）。此外，高龄（HR：1.06，95%CI：1.01-1.12，p=0.021）与更高的肾小球滤过率（glomerular filtration rate, GFR）（HR：1.23，95%CI：1.02-1.42，p=0.024）均与长期死亡风险升高相关。<b>结论：</b>本研究表明，预后营养指数、年龄及肺功能是影响血液透析患者生存状况的关键因素。上述研究结果凸显了开展全面营养与肺功能评估对改善该类患者临床结局的重要性。