title: Does body fat mass define survival in patients starting peritoneal dialysis?
abstract: OBJECTIVE
  Peritoneal dialysis (PD) is characterized by a gain in fat mass. Unlike subcutaneous fat, visceral fat is associated with metabolic syndrome and survival. We prospectively examined whether visceral or subcutaneous fat could predict outcome in patients undergoing PD.
  
  
  METHODS
  We studied 117 new patients (57 men) undergoing PD between February 2006 and November 2011. Baseline body composition was measured on computed tomograms. Visceral obesity was defined as a visceral fat area exceeding 100 cm(2), and subcutaneous obesity, as a subcutaneous fat area exceeding 130 cm(2).
  
  
  RESULTS
  Among the 117 patients, 37 and 29 were diagnosed with visceral and subcutaneous obesity respectively. Visceral and subcutaneous obesity were both present in 21 patients. In the study population, the 1-year and 5-year survival rates were 94% and 59%. The rates of peritonitis and exit-infection were 0.31 and 0.14 episodes per patient-year. Mortality was greater in patients with visceral obesity than in those without visceral obesity (p = 0.005). Visceral obesity had no influence on peritonitis and exit-infection rates. Subcutaneous obesity was associated neither with survival nor with peritonitis or exit-site infection. In a multivariate Cox regression analysis, visceral obesity was not a risk factor for poor outcome.
  
  
  CONCLUSIONS
  Increased visceral fat at PD initiation is not an independent predictor of poor survival. Any impact of visceral or subcutaneous fat mass on outcomes in patients undergoing PD would be better defined by larger, long-term studies.
authors: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, Korea.
authors: Soo Jeong
authors: SJ
authors: Choi
authors: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, Korea.
authors: Eun Jung
authors: EJ
authors: Kim
authors: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, Korea.
authors: Moo Yong
authors: MY
authors: Park
authors: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, Korea.
authors: Jin Kuk
authors: JK
authors: Kim
authors: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, Korea.
authors: Seung Duk
authors: SD
authors: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000401:mortality* / Q000503:physiopathology; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000503:physiopathology*; D015996:Survival Rate; D055815:Young Adult
keywords: Body composition
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