Abstract
Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent. Objective: To evaluate impact of BMI on cohort of incident elderly PD patients over time. Prospective multicenter cohort study (December / 2004-October/2007) with 674 patients. Socio-demographic and clinical data evaluated with patients followed until death, transfer to hemodialysis (HD), recovery of renal function, loss of follow-up or transplant. Patients were divided into incident on renal replacement therapy (RRT) for PD (PD first: 230) and transferred from hemodialysis (HD first: 444). Analysis was performed comparing these two groups using chi-square or Kruskal Wallis. Similar analysis was used to compare patients on automated peritoneal dialysis (APD) vs. continuous ambulatory peritoneal dialysis (CAPD). Data were compared between patients according to BMI by ANOVA, Kruskal Wallis or chi-square. For analysis of survival, Kaplan Meier method was used and to adjust confounding variables, Cox regression proportional hazard. Joint model for longitudinal and time-dependent data was conducted, assessing impact that a longitudinal variable displays on time of survival. Malnourished patients (76.79 ± 7.53 years) were older (p < 0.0001) with higher percentage of death (44.6%, p = 0.001); diabetes mellitus showed high prevalence in obese patients (68%, p < 0.0001); higher blood pressure levels (p = 0.002) were present in obese and overweight patients. Increased BMI variation over time proved to be a protective factor, with a decrease of about 1% in risk of death for every BMI unit earned.
Highlights
Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent
Socio-demographic and clinical data evaluated with patients followed until death, transfer to hemodialysis (HD), recovery of renal function, loss of follow-up or transplant
Patients were divided into incident on renal replacement therapy (RRT) for PD (PD first: 230) and transferred from hemodialysis (HD first: 444)
Summary
Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent. Objective: To evaluate impact of BMI on cohort of incident elderly PD patients over time. Data were compared between patients according to BMI by ANOVA, Kruskal Wallis or chi-square. The increase in life expectancy evidenced by the world’s population in recent decades has brought as a consequence a higher prevalence of diabetes mellitus (DM), hypertension and chronic kidney disease (CKD), frequent non-transmissible diseases among the elderly.[1]. This is one of the reasons for the significant increase in the incidence of elderly patients (≥ 65 years) on renal replacement therapy (RRT) in recent years. It can be recognized as a predictor of CKD.[6]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have