POS-548 THE INCIDENTS OF BASELINE OBESITY AND ACQUIRED GLUCOSE INTOLERANCE IN NEW CHINESE PERITONEAL DIALYSIS PATIENTS

Abstract

Acquired glucose intolerance is common and adversely affects the prognosis of new peritoneal dialysis (PD) patients. Since the prevalence of obesity increased in the general population worldwide over the past decades, we examined the change in the incidence of obesity and new-onset glucose intolerance in incident Chinese PD patients over the past 25 years. We reviewed the body built and fasting plasma glucose of incident PD patients in a single Hong Kong center from 1995 to 2019. The results are reported in five 5-year periods. We reviewed 1681 incident PD patients. Their mean age was 58.4 ± 12.5 years; 931 patients (55.4%) had pre-existing diabetes. From 1995-1999 to 2015-2019, the prevalence of obesity or overweight at the initiation of PD increased progressively for every 5-year period (from 21.9%, 26.2%, 37.9%, 42.7%, to 47.3%, p <0.001 for linearity). The increase in the prevalence of obesity or overweight was more pronounced in diabetic patients (33.7% to 59.6%) than non-diabetic ones (13.2% to 32.3%). Among non-diabetics, the incidence of new-onset impaired fasting glucose after initiation of PD gradually increased from 1995 to 2019 (from 29.2%, 35.2%, 32.2%, 33.6%, to 34.4% for every 5-year period), and the incidence of new-onset diabetes similarly increased during that period (from 18%, 19.7%, 17.8%, 22.4%, to 23.3%). The incidence of acquired impaired fasting glucose or diabetes was significantly higher in obese or overweight patients than those without overweight (56.9% vs. 51.4%, p <0.001), but the incidence remained substantial in the latter group. The incidents of obesity and overweight increase significantly in both diabetic and non-diabetic new PD patients in Hong Kong over the past 25 years. The incident of new-onset glucose intolerance or diabetes also increased during this period in non-diabetic PD patients, especially amongst obese or overweight ones. The prognostic implication and impacts on the healthcare system deserve further studies.