Introduction: A high body mass index (BMI) is a positive predictor of outcome in hemodialysis. But reports for peritoneal dialysis (PD) have been less numerous. The aim of the present investigation was to study the association between BMI and survival among PD patients and to discuss the main risk factors affecting survival. Materials and methods: A total of 159 patients who received PD from 1 January 2006 to 31 December 2010 at the Department of Nephrology in the Third Affiliated Hospital of Soochow University were enrolled in the study. Blood samples and baseline characteristics of the study cohort were obtained at the start of PD. Patient survival status was recorded through 31 December 2010. Results: Patients were stratified into two groups as normal weight (BMI, 18.5-24.9) and overweight (BMI, 25.0-29.9). KaplanMeier survival curve revealed that the normal weight patients had survival advantage over overweight patients (p < 0.01, by log-rank test). Cox proportional hazard models revealed that BMI, age, diabetes mellitus, coronary vascular disease, congestive heart failure and lipoprotein(a) (Lp(a)) were significant risk factors associated with all-cause mortality (p < 0.05). After adjustment for these covariates, survival was consistently higher for normal weight patients (p < 0.01). Furthermore, the study demonstrated that normal weight patients had lower serum Lp(a) (p < 0.05), C-reactive protein (CRP) (p < 0.05), and peritonitis rate (p < 0.05) compared with overweight patients. Conclusion: The results indicated that normal BMI at the commencement of PD had significant survival advantage in our study. The mechanisms for this might be related to lower cardiovascular risk, less chronic inflammation, and peritonitis prevalence.
Background: Much attention has been paid to the quality of life (QOL) in dialysis patients worldwide. However, differences in QOL between peritoneal dialysis (PD) and hemodialysis (HD) patients have not been clearly identified. The objectives of this study were to compare the differences of QOL between PD and HD patients, and to investigate factors contributing to QOL in the Chinese population. Methods: All patients who received PD or HD more than 3 months were enrolled in the study. The demographic and clinical data were also obtained. SF-36 was used to assess QOL. Results: A total of 190 (91.8%) of 207 dialysis patients were enrolled in the study. PD patients had markedly lower scores on role-physical (RP) and bodily pain (BP) domains than HD patients, but had remarkably higher scores on role-emotional (RE) domain (p < 0.05). While the scores of physical component summary (PCS) and mental component summary (MCS) showed no differences between the two groups (p > 0.05). The results of the multiple linear regression analysis indicated that age and cerebrovascular disease had negative correlations with PCS (p < 0.01), whereas the serum prealbumin level had positive correlation with PCS (p < 0.05). The married status was negatively associated with MCS (p < 0.01). But the higher education level was positively associated with MCS (p < 0.01). Conclusions: There were no significant differences on QOL between the two dialysis modalities. The possible factors related to QOL were age, cerebrovascular disease, marital status, education, and serum prealbumin levels.
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