Weight change during the first year of peritoneal dialysis: Risk factors and prognostic implications

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BackgroundWeight gain is common amongst patients who start peritoneal dialysis (PD). However, the prevalence, risk factors, and long-term implications of body weight gain in new PD patients have not been explored. MethodsWe studied 444 consecutive new PD patients. Body weight at the time of initiation of PD and 1 year later, and related clinical factors, were reviewed. Patients were followed for 60.9 ± 32.8 months for survival analysis. ResultsThe mean weight change after 1 year of PD was 1.34 ± 3.27 kg; 109 patients (24.6%) had weight gain > 3 kg. Patients without any peritonitis episodes during the 1st year of PD had significantly more weight gain than those who had peritonitis (1.58 ± 3.17 vs. 0.16 ± 3.56 kg, p = 0.001). There were no significant correlations between body weight change and glucose load, peritoneal transport characteristics, dialysis adequacy index, or baseline residual renal function. For patients with weight loss > 0.5 kg, weight change within 0.5 kg, weight gain > 0.5–3.0 kg, and weight gain > 3 kg, the patient survival rates at 60 months were 45.0%, 54.8%, 54.0%, and 52.9%, respectively (p = 0.213), while technique survival were 28.1%, 40.3%, 40.8%, and 36.7%, respectively (p = 0.03). ConclusionWeight gain is common among Chinese patients during the 1st year of PD but is not associated with any adverse clinical outcome. In contrast, weight loss during the 1st year of PD is common amongst PD patients who have peritonitis, and is associated with worse technique survival subsequently.