title: Does Body Mass Index affect survival and technique failure in patients undergoing peritoneal dialysis?
abstract: BACKGROUND
  The aim of this study was to investigate the effect of Body Mass Index (BMI) on mortality and clinical outcomes in patients undergoing peritoneal dialysis (PD).
  
  
  METHODS
  In this retrospective study, 367 consecutive patients undergoing PD from 2001 to 2014 were included. One-hundred and eight were excluded from the study. Remaining 259 patients' demographic and clinical data on initiation of PD and clinical events during the study period were collected. Patients were separated into two groups as normal BMI (18.5-24.9 kg/m²) and increased BMI (≥25 kg/m²). The increased BMI patients were categorized into two subgroups: obese, ≥30 kg/m²; overweight, 24-29.9 kg/m².The outcomes of interest were compared between the groups. Patient and technique survival were investigated.
  
  
  RESULTS
  Normal weighted patients were 66% (N.=171), overweights were 24.3% (N.=63), and obese ones were 9.7% (N.=25) at commencement of PD therapy. Patients with increased BMI was older than the patients with normal BMI (P=0.001). There were no differences among other parameters (P>0.05). Mean patients' survival time was 64.8±4.4 months in normal weight patients. Survival rate was 91.5, 84.3, 76.6 and 58.2% at 1, 2, 3 and 5 years, respectively. Gender, administration way, pretreatment residual renal functions, incidence of catheter exit site/tunnel infection, pretreatment albumin levels and last systolic BP were the risk factors. Mean technique survival duration were 47.2±3.5 months. Technique survival rate was 86.5, 65.9, 53.7 and 29.9 % at 1, 2, 3 and 5 years, respectively. Age, Kt/V, incidence of peritonitis, catheter exit site/tunnel infection, pretreatment SBP and DBP were the risk factors. Mean patients' survival time was 63±5.2 months in increased BMI group. Survival rate was 81.3, 79.4, 75.1 and 53.6% at 1, 2, 3 and 5 years, respectively. Presences of HD history, incidence of peritonitis were the identified risk factors on patients' mortality. Mean technique survival duration were 57.1±4.8 months. Technique survival rate was 87.1, 76.1, 64.8 and 42% at 1, 2, 3 and 5 years, respectively. Pretreatment residual renal function, SBP and DBP were predictors of technique survival. There was no difference in patients and technique survival between groups (P>0.05).
  
  
  CONCLUSIONS
  The PD patients with increased BMI at initiation of PD do have a similar survival when compared with patients with normal BMI.
authors: Department of Nephrology, Sisli Etfal Research And Educational Hospital, Istanbul, Turkey - tanerbast@yahoo.com.
authors: Tamer
authors: T
authors: Sakaci
authors: Elbis
authors: E
authors: Ahbap
authors: Taner
authors: T
authors: Basturk
authors: Yener
authors: Y
authors: Koc
authors: Ekrem
authors: E
authors: Kara
authors: Mustafa
authors: M
authors: Sevinc
authors: Zuhal
authors: Z
authors: Ucar
authors: Feyza
authors: F
authors: Caglayan
authors: Arzu
authors: A
authors: Kayalar
authors: Tuncay
authors: T
authors: Sahutoglu
authors: Cuneyt
authors: C
authors: Akgul
authors: Yşe
authors: Y
authors: Sinangil
authors: Abdulkadir
authors: A
authors: Unsal
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality; D050177:Overweight / Q000150:complications / Q000401:mortality; D010530:Peritoneal Dialysis / Q000379:methods*; D015996:Survival Rate; D017211:Treatment Failure