Body size and longitudinal body weight changes do not increase mortality in incident peritoneal dialysis patients of the Brazilian peritoneal dialysis multicenter study

作者：da Silva Fernandes Natalia Maria; Bastos Marcus Gomes; Gianotti Franco Marcia Regina; Chaoubah Alfredo; Lima Maria da Gloria; Divino Filho Jose Carolino; Qureshi Abdul Rashid

来源：Clinics, 2013, 68(1): 51-58.

DOI：10.6061/clinics/2013(01)OA08

• Overweight
• Obesity
• Incident
• Peritoneal Dialysis
• Survival
• Cohort Study

OBJECTIVES: To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients.
PATIENTS AND METHODS: Patients (n = 1911) older than 18 years of age recruited from 114 dialysis centers (Dec/ 2004-Oct/2007) and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died).
RESULTS: Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female). The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index <18.5 kg/m(2), a neutral risk between 25 and 29.9 kg/m(2) and a protective effect for an index >30 kg/m(2). Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: < -3.1%, -3.1 to+0.12%, +0.12 to <+3.1% (reference category), +3.1 to +7.1% and >+7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles.
CONCLUSION: These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil.

• 出版日期2013