title: Excessive Weight Gain during the First Year of Peritoneal Dialysis Is Associated with Inflammation, Diabetes Mellitus, and a Rapid Decrease in Residual Renal Function.
abstract: OBJECTIVE
  Significant weight gain is a potential problem in most patients starting peritoneal dialysis (PD); however, few studies have explored the clinical effects of increased body weight (BW) in these patients. We evaluated the effect of excess weight gain during the first year after PD on residual renal function (RRF).
  
  
  METHODS
  A total of 148 incident PD patients were analyzed in a longitudinal observational study. The mean duration of follow-up was 23.8 months. RRF was measured at baseline (within 1 month of starting PD) and thereafter at 6-month intervals for 2-3 years or until loss of RRF. BW was measured at the time of RRF measurement, and excess weight gain was defined as a BW increase over the median value (3.0%).
  
  
  RESULTS
  The median 1-year increase in BW was 2.3kg (IQR, 1.01-4.58) or 3.0% (IQR, 1.13-5.31). The mean slope of RRF decline was -0.068 ± 0.053 mL/min/month/1.73m2, and RRF loss developed in 48 patients at a mean follow-up time of 19.4 ± 6.8 months. Patients with BW increases > 3.0% showed significantly increased RRF decline rate compared to those without excess weight gain (p<0.001), and the BW increase (%/year) correlated significantly with higher hs-CRP levels and RRF decline rate. High systolic blood pressure, diabetes, large amount of proteinuria and excess BW gain significantly influenced the RRF decline rate. Also, it increased the risk of RRF loss by 4.17-fold (95% confidence intervals, 1.87-9.28; p<0.001).
  
  
  CONCLUSIONS
  Excess weight gain during the first year of PD was closely linked to systemic inflammation, diabetes and rapid decline in RRF.
authors.affiliation: Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea.
authors.forename: Jwa-Kyung
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea.
authors.forename: Young-Su
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea.
authors.forename: Young Rim
authors.initials: YR
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea.
authors.forename: Hyung Jik
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea.
authors.forename: Sung Gyun
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Moon
mesh_terms: D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D015430:Weight Gain