P1568EFFECTS OF VOLUME STATUS ON BODY COMPOSITION IN INCIDENT PERITONEAL DIALYSIS PATIENTS

Abstract

Abstract Background and Aims Volume control is the most important issue in peritoneal dialysis (PD). Inadequate fluid removal or high water intake leads to overhydration, which result in malnutrition. Sarcopenia (SP) as a result of malnutrition is more prevalent in PD than in the general population, and is associated with high mortality and low quality of life in PD patients. The aim of the present study was to evaluate the effects of volume status on body composition in incident PD patients. Method This retrospective study was performed at a tertiary medical center from January 2001 to March 2015. All incident PD patients who survived ≥1 year after PD initiation were considered eligible. 366 incident PD patients were finally included and divided into 3 tertiles according to the time-averaged-edema index (TA-EI). Edema index was calculated by dividing extracellular water values by total body water values. The mean of the EI values at 1 month and 1 year was defined as TA-EI. The body composition parameters measured using bioimpedance analysis included the EI, fat mass index (FMI, kg/m2), and appendicular muscle mass index (AMMI, kg/m2). dFMI and dAMMI were defined as delta values for each variable. The cutoff value for sarcopenia (SP) was defined as previously reported (The cutoff value for SP was defined as AMMI ≤ 7.0 kg/m2 in men and ≤ 5.7 kg/m2 in women). Patients with AMMI below the cut-off values were defined as having SP. Results The number of participants in the low, middle, and high tertiles was 126, 100, and 140, respectively. The TA-EI in the low, middle, and high tertiles was 0.384 ± 0.006, 0.398 ± 0.003, and 0.413 ± 0.009, respectively (P < 0.001). A high volume status was associated with high solute clearance, peritoneal albumin loss, and glucose absorption through the peritoneal membrane, which led to high dialysate glucose. In addition, volume status was inversely associated with increases in AMMI, but was not associated with changes in FMI. SP as a categorical variable was positively associated with a high volume status. On subgroup analyses, TA-EI had the greatest negative correlation coefficients for dAMMI. Conclusion Overhydration in PD patients was associated with decrease in muscle mass indices and the development of SP.