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

摘要：

目的 应用总钠清除量测定法评估维持性腹膜透析（maintenance peritoneal dialysis，MPD）患者钠摄入现状并分析其影响因素，为改善腹膜透析护理质量提供参考。 方法 采用横断面研究设计，选取2025年12月至2026年2月天津市某三级甲等医院肾内科腹膜透析中心448例MPD患者为调查对象。通过总钠清除量测定法评估钠摄入水平，分为低钠摄入组（<1 200 mg/d）、适宜钠摄入组（1 200~2 000 mg/d）、高钠摄入组（>2 000~2 800 mg/d）及过高钠摄入组（>2 800 mg/d）。比较4组的临床特征差异，并采用多元Logistic回归分析钠摄入的影响因素。 结果 回收有效问卷317份，MPD患者钠摄入为2 855.15（2 197.66，3 589.12）mg/d，折合食盐约7.30（5.60，9.10）g/d。钠摄入达标率（1 200~2 000 mg/d）为12.93%，低钠摄入占3.15%、高钠摄入占32.49%、过高钠摄入占51.42%。钠摄入量与体重指数、收缩压、舒张压、尿量、血尿素及血钾呈正相关，与年龄呈负相关（均P<0.05）。多元Logistic回归分析显示，年龄较大是低钠摄入的独立危险因素（OR=1.283，P=0.043），体重指数是高钠及过高钠摄入的独立危险因素（OR=1.172，P=0.038；OR=1.202，P=0.014），标准化蛋白质分解代谢率是过高钠摄入的独立危险因素（OR=5.953，P=0.037）。 结论 MPD患者钠摄入达标率较低，过高钠摄入与低钠摄入并存现象突出。护理人员应针对高体重指数患者强化体重管理，针对年龄较大患者加强营养监测，建立个体化钠摄入评估体系。

关键词: 腹膜透析, 钠摄入, 膳食, 营养管理, 影响因素分析, 护理