关键词: 腹膜透析, 钠摄入, 膳食, 营养管理, 影响因素分析, 护理

Abstract:

Objective This study aimed to assess sodium intake in maintenance peritoneal dialysis（MPD） patients using total sodium removal measurement，analyze its influencing factors，and provide a reference for improving the quality of peritoneal dialysis nursing care. Methods A cross-sectional survey was conducted among 448 MPD patients at the Peritoneal Dialysis Center，Department of Nephrology，Tianjin First Central Hospital from December 2025 to February 2026. Sodium intake was evaluated using total sodium removal measurement and classified into 4 groups：a low sodium intake group（<1 200 mg/d），an appropriate sodium intake group（1 200~2 000 mg/d），a high sodium intake group（>2 000~2 800 mg/d），and an excessive sodium intake group（>2 800 mg/d）. Intergroup comparisons of clinical characteristics were performed using Kruskal-Wallis H test or χ² test. Spearman correlation analysis and multivariate logistic regression were employed to identify factors associated with sodium intake. Results A total of 317 valid questionnaires were collected. The median sodium intake was 2 855.15（2 197.66~3 589.12） mg/d，equivalent to 7.30（5.60~9.10） g/d of dietary salt. The rate of achieving appropriate sodium intake（1 200~2 000 mg/d） was 12.93%，with 3.15% in the low sodium intake，32.49% in the high sodium intake group，and 51.42% in the excessive sodium intake group. Sodium intake was positively correlated with body mass index，systolic blood pressure，diastolic blood pressure，urine volume，blood urea nitrogen，and serum potassium，and negatively correlated with age（all P<0.001）. Multivariate logistic regression showed that advanced age was an independent risk factor for low sodium intake（OR=1.283，P=0.043），and body mass index was an independent risk factor for both high（OR=1.172，P=0.038） and excessive（OR=1.202，P=0.014） sodium intake，and normalized protein catabolic rate（nPCR） was an independent risk factor for excessive sodium intake（OR=5.953，P=0.037）. Conclusion The achievement rate of appropriate sodium intake is extremely low among MPD patients，with a prominent coexistence of both excessive and insufficient sodium intake. Nursing staff should strengthen weight management for patients with high body mass index，enhance nutritional monitoring for elderly patients，and establish individualized sodium intake assessment systems.

Key words: Peritoneal Dialysis, Sodium Intake, Dietary, Nutritional Management, Root Cause Analysis, Nursing Care