The clinical data of maintenance hemodialysis (MHD) patients from twenty hemodialysis centers in Guizhou province from June to September 2020 were collected by cross-sectional study. The patients were divided into AFD group and non-AFD group according to whether AFD had occurred. LTI was measured by body composition monitor. The results showed that the incidence of AFD in 2 781 MHD patients was 30.0% (835/2 781). Median LTI level was 15.2 (13.2, 17.5) kg/m2. The LTI level in the AFD group was higher than that in the non-AFD group (P < 0.05). According to the tertiles of LTI, low LTI group (LTI ≤ 13.9 kg/m2) had the highest incidence of AFD (35.5%, 334/940), and the high LTI group had the lowest incidence of AFD (26.3%, 241/916), and the difference among the three groups was statistically significant (χ2=20.182,P < 0.001). Multivariate logistic regression analysis showed that low LTI group as the reference, the risk of AFD in moderate LTI group (13.9 kg/m2 < LTI ≤ 16.6 kg/m2) and high LTI group were associated with the 20.0% (OR=0.800, 95% CI 0.650-0.986, P=0.036) and 22.8% (OR=0.772, 95% CI 0.616-0.966, P=0.024) decrease, respectively. These results suggest that low LTI level is independently associated with an increased risk of AFD in MHD patients.
通过多中心横断面研究分析2020年6月1日至2020年9月30日贵州省20家血液透析中心接受维持性血液透析（maintenance hemodialysis，MHD）治疗患者的临床资料，探讨瘦组织指数（lean tissue index，LTI）水平与动静脉内瘘丧失功能（arteriovenous fistula dysfunction，AFD）的相关关系。根据是否发生AFD分为AFD组和非AFD两组，用人体成分分析仪测量LTI。结果发现，2 781例MHD患者的AFD发生率为30.0%（835/2 781）；中位LTI水平为15.2（13.2，17.5）kg/m2。与非AFD组相比，AFD组患者LTI较低（P < 0.05）。按LTI三分位数分组中，低LTI组（LTI ≤ 13.9 kg/m2）AFD发生率最高（35.5%，334/940），高LTI组（LTI > 16.6 kg/m2）AFD发生率最低（26.3%，241/916），3组的差异有统计学意义（χ2=20.182，P < 0.001）。多因素Logistic回归分析结果显示，中LTI组（13.9 kg/m2 < LTI ≤ 16.6 kg/m2）和高LTI组发生AFD的风险均低于低LTI组（以低LTI组为参照，OR=0.800，95% CI 0.650～0.986，P=0.036；OR=0.772，95% CI 0.616～0.966，P=0.024）。提示MHD患者低水平LTI与AFD风险增加独立相关。.