OBESITY IS NOT ASSOCIATED WITH INCREASED MORTALITY IN AUSTRALIA AND NEW ZEALAND PERITONEAL DIALYSIS PATIENTS

S MURTHY1, S ULLAH2, J BARBARA1,3, G PASSARIS1, S MCDONALD2,4,5, R JUNEJA1,3

1 Flinders Medical Centre, Adelaide, South Australia; 2ANZDATA Registry, Adelaide, South Australia; 3Flinders University, Adelaide, South Australia; 4Royal Adelaide Hospital, Adelaide, South Australia; 5The University of Adelaide, Adelaide, South Australia

Aim: This study aimed to investigate the association of body mass index (BMI) with peritoneal dialysis outcomes in Australia and New Zealand patients.

Background: The association of BMI with peritoneal dialysis outcomes remains uncertain. There have been numerous studies with varied associations.

Methods: ANZDATA registry data for 10,364 incident peritoneal dialysis patients between 1 April 2002 and 31 March 2014 were analysed. Patients were assigned to 4 BMI categories: Underweight (<18.5), Normal (18.5 – 24.9), Overweight (25 – 29.9) and obese (≥30). A multivariate Cox model and competing risk analysis were performed to predict technique and patient survival.

Results: Of the 10,364 patients, almost 27% (n=2,806) were obese. Obesity was associated with a risk of technique failure (HR, 1.24; 95% CI, 1.16 – 1.32; P<0.001) but not with increased mortality (HR, 1.04; 95% CI, 0.96 – 1.13; P= 0.31). The overall technique failure rate (per 1000 person-years) showed a declining trend (P<0.004). Underweight status was strongly associated with increased mortality (HR, 1.32; 95% CI, 1.10 – 1.58; P < 0.01). For cardiovascular events, both overweight and obesity were strongly associated with increased mortality (HRs, 1.24 and 1.47; 95% CI, 1.12 to 1.39 and 1.32 to 1.64; P <0.001 respectively). Standard Cox proportional hazards and competing risk models showed almost similar results for patient survival.

Conclusions: Underweight status is associated with increased mortality for peritoneal dialysis patients. Obesity is not associated with increased mortality but continues to be associated with a risk of technique failure. The data also suggests a declining trend over the study duration in technique failure. Underweight patients need careful evaluation before commencement on peritoneal dialysis.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

Conference Managers

Please contact the team at Conference Design with any questions regarding the Annual Scientific Meeting

/wp-content/uploads/2017/08/Conference-Design-400×400.png

© 2015 - 2016 Conference Design Pty Ltd