关键词: 腹膜透析, 老年营养风险指数, 肌少症指数

Abstract: Ｏｂｊｅｃｔｉｖｅ：To evaluate the feasibility of geriatric nutritional risk index （GNRI） combined with sarcopenia index （SI） in assessment of clinical events in peritoneal dialysis （PD） patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：In this retrospective cohort study， patients underwent maintained PD at Jinling hospital were enrolled from July 2020 to June 2021. We collected baseline clinical characteristics of the participants. Serum albumin （Alb）， creatinine （Cr）， cystatin C （CysC） were measured by standard laboratory techniques. The GNRI was calculated with weight and Alb. All patients were examined by transthoracic echocardiography to measure the diameter of the left ventricle. Left ventriclar mass index （LVMI） was obtained by calculation. Abdominal lateral plain radiograph and multi-slice spiral CT were used to detect the calcification of abdominal aorta and coronary artery， respectively. Kauppila score was used to assess the degree of abdominal aortic calcification score （AACS）， and Agatston score for the degree of coronary artery calcification score （CACS）. Pearson correlation coefficient was used to analyze the relationship between GNRI，SI and CACS， LVMI. We also used receiver operator characteristic （ROC） curves to assess the accuracy and sensitivity of GNRI，SI score for the diagnosis of clinical events （mortality， technique failure）.
Ｒｅｓｕｌｔｓ：A total of 296 PD patients were enrolled in the final analysis. The mean age of our participants was 51.2 years. Among them， 141（47.6%） were males. PD treatment modality was mainly DAPD， and mean PD vintage was 60.5 months. Dialysis adequacy data shown with total （renal+peritoneal） Kt／V was 1.79±0.62. Mean SI was 0.77 and GNRI was 92.6. Correlation analysis showed that GNRI （r=-0.26，P<0.01） or SI （r=-0.20， P<0.01） score was negatively correlated with CACS， respectively. A total of 196 composite outcomes occurred: 29 all-cause of deaths and 155 technique failure occurred during a median follow-up of 2 years. Logistic regression analyses showed that nPCR， LVMI and SI were related to the prevalence of composite outcomes. The area under the receiver-operating characteristic curve （AUC） of GNRI or SI score for diagnosing composite outcomes was 0.70 or 0.77， respectively. When GNRI combined with the SI score， the prediction of composite outcomes became more powerful for PD patients.
Ｃｏｎｃｌｕｓｉｏｎ：GNRI or SI score was significantly correlated with coronary artery calcification. GNRI can be combined with SI score to predict the composite outcomes in PD patients.

Key words: peritoneal dialysis, geriatric nutritional risk index, sarcopenia index