title: Association of Body Mass Index and Body Mass Index Change with Mortality in Incident Peritoneal Dialysis Patients.
abstract: Although high body mass index (BMI) appears to confer a survival advantage in hemodialysis patients, the association of BMI with mortality in continuous ambulatory peritoneal dialysis (CAPD) patients is uncertain. We enrolled incident CAPD patients and BMI was categorized according to World Health Organization classification for Asian population. BMI at baseline and one year after the initiation of peritoneal dialysis (PD) treatment was assessed to calculate the BMI change (∆BMI). Patients were split into four categories according quartiles of ∆BMI. Kaplan-Meier method and Cox regression proportional hazard analysis were performed to assess the association of BMI on outcomes. A total of 1263 CAPD patients were included, with a mean age of 47.8 ± 15.0 years, a mean BMI of 21.58 ± 3.13 kg/m². During a median follow-up of 25.3 months, obesity was associated with increased risk for cardiovascular diseases (CVD) death (adjusted hazard ratio (AHR) 2.01; 95% CI 1.14, 3.54), but not all-cause mortality. Additionally, patients with more BMI decline (>0.80%) during the first year after CAPD initiation had an elevated risk for both all-cause (AHR: 2.21, 95% CI 1.23-3.95) and CVD mortality (AHR 2.31, 95% CI 1.11, 4.84), which was independent of baseline BMI values.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China. xiongliping2000@126.com.
authors.forename: Liping
authors.initials: L
authors.lastname: Xiong
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China. bcone@163.com.
authors.forename: Shirong
authors.initials: S
authors.lastname: Cao
authors.affiliation: Epidemiology Research Unit and Translational Medicine Research Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China. xufenghua0411@126.com.
authors.forename: Fenghua
authors.initials: F
authors.lastname: Xu
authors.affiliation: Epidemiology Research Unit and Translational Medicine Research Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China. zhouqian2017@163.com.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China. lfan6262@gmail.com.
authors.forename: Li
authors.initials: L
authors.lastname: Fan
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China. xqd82@163.com.
authors.forename: Qingdong
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China. yuxq@mail.sysu.edu.cn.
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health of China, Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China. haipingmao@126.com.
authors.forename: Haiping
authors.initials: H
authors.lastname: Mao
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality; D002681:China; D048909:Diabetes Complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000401:mortality*; D016016:Proportional Hazards Models; D012189:Retrospective Studies
keywords: body mass index; body mass index change; continuous ambulatory peritoneal dialysis; mortality