Nosocomial & Healthcare-associated Infections | Dialysis & Renal Transplantation | Diabetes & Obesity | Methods for Diagnostic & Therapeutic Studies
Does body fat mass define the survival in patients starting peritoneal dialysis?
Kyong Ah Park, Eun Jung Kim, Na Ri Kim, Soo Jeong Choi, Moo Yong Park, Jin Kuk Kim, Seung Duk Hwang*
*Corresponding author: Seung Duk Hwang
Department of Internal Medicine, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea, South
F1000Posters 2011, 2: 1121 (poster) [ENGLISH]
Poster [317.98 KB]
48th Congress of the European Renal Association and European Dialysis and Transplant Association 2011, 23 - 26 Jun 2011, S-503
Visceral fat is more associated with metabolic syndrome and atherosclerosis than subcutaneous fat mass in both obese and normal weight individuals. Additionally, the change of visceral fat mass is a more reliable predictor of survival in peritoneal dialysis (PD) patients. Some reports revealed high body mass index (BMI) is a predictor of good prognosis. But, obesity is a risk factor for peritonitis. As BMI doesn’t reflect hydration status in patients with PD, some previous studies tried to reveal the impact of visceral and subcutaneous fat on survival during PD. We examined whether visceral and subcutaneous fat mass were associated with outcomes in patients undergoing PD.
We studied 94 new PD patients (46 males) between February 2006 and June 2010. Baseline body composition measured by computed tomogram (CT) and nutrition status were assessed on the seventh day after the start of PD. We define primary and secondary outcome as death and peritonitis/exit infection, respectively.
Average follow-up was 25.3 ± 15.7 months. The 1-year survival and 5-year survival was 91% and 84%, respectively. Age, diabetes mellitus (DM), cardiovascular disease (CVD), albumin, hs-CRP, fat mass percent, mitral annular calcification (MAC), and visceral/subcutaneous (V/S) ratio were closely related with survival. However, the multivariate Cox regression model demonstrated that age and CVD were independent predictors for poor outcome. Patients with visceral obesity had poor outcomes compared with those without visceral obesity. The peritonitis and exit infection rate were 31% and 14% at 1st year, respectively. Only subcutaneous obesity was a risk factor for not peritonitis, but exit infection Multivariate Cox regression showed subcutaneous obesity is a risk factor for exit infection.
Increased visceral fat at initiation of PD may be a predictor of poor outcome. Subcutaneous fat mass was a risk factor of exit infection.
No relevant conflicts of interest declared.
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