title: Peritoneal dialysis outcomes in a modern cohort of overweight patients.
abstract: BACKGROUND
  The incidence of obesity is increasing both in the general population and in incident dialysis patients. While there is evidence that being overweight is associated with good outcomes in hemodialysis, the evidence in peritoneal dialysis (PD) patients is not very clear. We studied a modern cohort of PD patients to examine outcomes in large patients.
  
  
  METHODS
  Forty-three patients who started PD, who weighed more than 90 kg at dialysis initiation, between January/2000 and June/2010 were matched with 43 control patients who weighed less than 90 kg. Detailed review of the charts was undertaken.
  
  
  RESULTS
  The mean weight and body mass index of the wt < 90 kg group were 69.3 ± 11.3 kg and 25.0 ± 3.9 kg/m(2). The number of peritonitis episodes per year was 0.33 ± 0.6 (wt < 90 kg) and 0.82 ± 1.7 (wt ≥ 90 kg) (p = 0.26). The median time to first peritonitis showed a trend toward earlier peritonitis in larger patients [9.5 (4.3, 27) months in wt ≥ 90 kg, 19.1(7.9, 30.8) months in wt < 90 kg] but did not reach statistical significance (p = 0.12). Surprisingly, hernias and leaks were more common in the weight <90 kg group (44 vs. 18.6 % p = 0.02). There was no difference in total number of hospitalizations or the number of days hospitalized. Kaplan-Meier analysis of survival on PD showed no differences between the two groups (logrank p = 0.99). Cox regression analysis using age, race, cause of ESRD due to diabetes and Charlson comorbidity index as the covariates did not show weight to be associated with survival on PD.
  
  
  CONCLUSIONS
  Large patients tend to do just as well on PD, with survival on PD being no different compared to individuals with lower weight and body mass index.
authors.affiliation: The Home Peritoneal Dialysis Unit, University Health Network, Toronto General Hospital, University of Toronto, 200 Elizabeth Street, 8N-840, Toronto, ON, M5G 2C4, Canada.
authors.forename: Shubha
authors.initials: S
authors.lastname: Ananthakrishnan
authors.forename: Nigar
authors.initials: N
authors.lastname: Sekercioglu
authors.forename: Rosilene M
authors.initials: RM
authors.lastname: Elias
authors.forename: Joseph
authors.initials: J
authors.lastname: Kim
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Oreopoulos
authors.forename: Maggie
authors.initials: M
authors.lastname: Chu
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Bargman
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D046449:Hernia, Abdominal / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors