Survival Advantage of Normal Weight in Peritoneal Dialysis Patients

Zhou, Hua; Cui, Li; Zhu, GeYa; Jiang, Yaping; Gao, Xiaoxia; Zhou, Yun; Liu, Hua; Jia, Di; Zong, Yin; Pan, JiaRong

doi:10.3109/0886022x.2011.615968

Cited by 17 publications

(24 citation statements)

References 25 publications

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“…29 However, obesity is found to be a risk factor for mortality in small number of peritoneal dialysis patients. 30 We did not found any associations between BMI values or obesity (BMI ! 30 kg/m 2 ) and mortality.…”

Section: Parametermentioning

confidence: 69%

The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study

Özener¹,

Arıkan

Karayaylalı³

et al. 2013

Renal Failure

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Purpose: It is well established that diabetic peritoneal dialysis (PD) patients have a higher mortality rate than the other PD population. This study was designed to determine the overall predictors of survival and compared mortality and morbidity between diabetic and non-diabetic Turkish PD patients. Methods: We conducted a multicenter retrospective study with 915 PD patients [217 had diabetes mellitus (DM)]. Serum albumin, PTH, HbA1c, co-morbid diseases, dialysis adequacy (Kt/V), and peritoneal transport characteristics as well as peritonitis episodes and ultrafiltration failure during the follow-up period were recorded. Results: DM patients were older and had more co-morbidities than non-DM patients. Peritonitis rates were higher in DM patients (one episode per 35.9 patient months) compared to non-DM patients (one episode per 41.5 patient months) (p50.001). On Kaplan-Meier analysis, patient survival was significantly lower in DM patients with the 2-, 3-and 5-year patient survival rates of 90.8%, 87.8% and 78.2% in non-diabetics and 80.9%, 70.4% and 61.2% in diabetics, respectively. On Cox regression analysis, DM (HR 1.5, p ¼ 0.022), age (HR 1.03, p50.001), baseline serum albumin (HR 0.39, p50.001), heart failure (HR 0.038, p ¼ 0.038), peripheral artery disease (HR 1.83, p ¼ 0.025) and amputation (HR 4.1, p ¼ 0.009) at baseline were significant predictors of overall mortality. Conclusions: Patient survival is lower in diabetic compared to non-diabetic patients on PD. Peritonitis rates were also higher in diabetic PD patients. DM, older age, albumin level and cardiovascular co-morbidities are predictors of mortality

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Section: Parametermentioning

confidence: 69%

The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study

Özener¹,

Arıkan

Karayaylalı³

et al. 2013

Renal Failure

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“…In contrast, the impact of BMI on survival in peritoneal dialysis (PD) patients is inconsistent. Some studies have suggested a similar protective effect of BMI (12-15), some have suggested a neutral effect (11,16), and some have indicated that survival is worse in obese patients (17,18).The relationship between BMI and mortality might be different in dialysis patients of different ethnicities. Wong et al (9) were the first to report a difference in the impact of BMI on survival in white and Asian HD patients within the United States.…”

mentioning

confidence: 99%

“…In contrast, the impact of BMI on survival in peritoneal dialysis (PD) patients is inconsistent. Some studies have suggested a similar protective effect of BMI (12)(13)(14)(15), some have suggested a neutral effect (11,16), and some have indicated that survival is worse in obese patients (17,18).…”

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confidence: 99%

Body Mass Index and Mortality Risk in Asian Peritoneal Dialysis Patients in Hong Kong—Impact of Diabetes and Cardiovascular Disease Status

et al. 2014

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♦ Background: Obesity increases mortality in the general population, but improves survival in hemodialysis patients. In peritoneal dialysis (PD) patients, the reported effect is controversial. We investigated the effect of body mass index (BMI) on patient survival in Asian PD patients. KEY WORDS: Body mass index; cardiovascular disease; diabetes; mortality.In the general population, body mass index (BMI) has an influence on health risk and survival. Increased risks for cardiovascular disease (CVD), diabetes mellitus (DM), and mortality are found in patients with overweight and obesity. A J-or V-shaped relationship between BMI and mortality risk is well documented in the general population, meaning that, although mortality increases with BMI, individuals with low a BMI also experience increased mortality, although not as high as that in obese individuals (1-5). However, in hemodialysis (HD) patients, higher BMI carries a protective effect with respect to patient survival (6-10)-a finding described as a "reverse epidemiology" phenomenon (11). In contrast, the impact of BMI on survival in peritoneal dialysis (PD) patients is inconsistent. Some studies have suggested a similar protective effect of BMI (12-15), some have suggested a neutral effect (11,16), and some have indicated that survival is worse in obese patients (17,18).The relationship between BMI and mortality might be different in dialysis patients of different ethnicities. Wong et al. (9) were the first to report a difference in the impact of BMI on survival in white and Asian HD patients within the United States. In contrast to the typical reverse epidemiology pattern found in white HD patients, Asian HD patients in the United States demonstrated a V-shaped mortality risk relationship, with the lowest risk found in the middle-quintile BMI group, corresponding to a BMI of approximately 23 kg/ m 2 . (The middle-quintile BMI for Caucasians is approximately 25 kg/m 2 .) This V-shaped relationship somewhat simulates the relationship in the general population (5). McDonald et al. (17) also found that the relationship was different in white and Pacific Islander PD patients in Australia and New Zealand. However, there is a paucity of such information for Asian PD populations living in Asia. It is also plausible that the relationship between mortality risk and BMI differs not only

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“…The influence of race on the outcomes of obesity in PD was confirmed by similar studies conducted in Asia[38] and in Australia and New Zealand[39]. Other studies reported either adverse effects[40,41] or no effect[42,43] of obesity on the survival of PD patients.…”

Section: Discussionmentioning

confidence: 64%

Advanced wasting in peritoneal dialysis patients

Murata

Glew

et al. 2017

WJN

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AIMTo identify patients with end-stage renal disease treated by peritoneal dialysis (PD) who had zero body fat (BF) as determined by analysis of body composition using anthropometric formulas estimating body water (V) and to compare nutritional parameters between these patients and PD patients whose BF was above zero.METHODSBody weight (W) consists of fat-free mass (FFM) and BF. Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73, where 0.73 is the water fraction of FFM at normal hydration. Wasting from loss of BF has adverse survival outcomes in PD. Advanced wasting was defined as zero BF when V/0.73 is equal to or exceeds W. This study, which analyzed 439 PD patients at their first clearance study, used the Watson formulas estimating V to identify patients with VWatson/0.73 ≥ W and compared their nutritional indices with those of PD patients with VWatson/0.73 < W.RESULTSThe study identified at the first clearance study two male patients with VWatson/0.73 ≥ W among 439 patients on PD. Compared to 260 other male patients on PD, the two subjects with advanced wasting had exceptionally low body mass index and serum albumin concentration. The first of the two subjects also had very low values for serum creatinine concentration and total (in urine and spent peritoneal dialysate) creatinine excretion rate while the second subject had an elevated serum creatinine concentration and high creatinine excretion rate due, most probably, to non-compliance with the PD prescription.CONCLUSIONAdvanced wasting (zero BF) in PD patients, identified by the anthropometric formulas that estimate V, while rare, is associated with indices of poor somatic and visceral nutrition.

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Survival Advantage of Normal Weight in Peritoneal Dialysis Patients

Cited by 17 publications

References 25 publications

The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study

The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study

Body Mass Index and Mortality Risk in Asian Peritoneal Dialysis Patients in Hong Kong—Impact of Diabetes and Cardiovascular Disease Status

Advanced wasting in peritoneal dialysis patients

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