title: Body size and longitudinal body weight changes do not increase mortality in incident peritoneal dialysis patients of the Brazilian peritoneal dialysis multicenter study.
abstract: OBJECTIVE
  To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients.
  
  
  METHODS
  Patients (n = 1911) older than 18 years of age recruited from 114 dialysis centers (Dec/ 2004-Oct/2007) and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died).
  
  
  RESULTS
  Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female). The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index <18.5 kg/m², a neutral risk between 25 and 29.9 kg/m² and a protective effect for an index >30 kg/m². Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: <-3.1%, -3.1 to+0.12%, +0.12 to <+3.1% (reference category), +3.1 to +7.1% and >+7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles.
  
  
  CONCLUSIONS
  These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil.
authors: Federal University of Juiz de Fora, Interdisciplinary Program of Studies, Research, and Treatment in Nephrology, Juiz de Fora/MG, Brazil. nataliafernandes02@gmail.com
authors: Natália Maria da Silva
authors: NM
authors: Fernandes
authors: Marcus Gomes
authors: MG
authors: Bastos
authors: Márcia Regina Gianotti
authors: MR
authors: Franco
authors: Alfredo
authors: A
authors: Chaoubah
authors: Maria da Glória
authors: Mda G
authors: Lima
authors: José Carolino
authors: JC
authors: Divino-Filho
authors: Abdul Rashid
authors: AR
authors: Qureshi
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D049628:Body Size / Q000502:physiology*; D001938:Brazil; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D050177:Overweight / Q000503:physiopathology*; D010530:Peritoneal Dialysis / Q000401:mortality*; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome