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Abstract: FR-PO552

Effects of Body Fat Accumulation During PD on Mortality and Technique Failure: Is There a Difference by PD Duration?

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Kim, Jwa-kyung, Hallym University, Seoul, Korea (the Republic of)
  • Joo, Narae, Halyym University Sacred Heart Hospital, AnYang, Korea (the Republic of)
  • Kim, Youngsu, Hallym Univ. Sacred Heart Hospital, Angyang, Korea (the Republic of)
  • Kim, Sung gyun, Hallym University, Seoul, Korea (the Republic of)
Background

Significant body fat accumulation is an inevitable but potentially serious problem in maintenance peritoneal dialysis (PD) patients. Whether excessive fat gain predicts long-term outcomes in these patients is still unknown.

Methods

In this prospective observational study of 296 patients, the association between excessive fat accumulation and patient survival and PD failure rates was analyzed. Patients were classified by dialysis duration at time of study enrollment into short- (<2years) and long-term (>2years) groups. Body weight (BW) and body composition analysis were measured twice, 12.8 ± 4.6 months apart. Excessive fat accumulation was defined as a 1-year change in body fat percentage (ΔPBF) over the highest quartile (5.0% for men, 5.4% for women).

Results

A substantial 1-year increase in BW and PBF were only observed in the short-term group (p<0.001, 0.027), whereas, in the long-term group, the changes were insignificant. In the short-term group, the ΔPBF was closely associated with unfavorable baseline metabolic profiles, including old age, diabetes, obesity, elevated blood pressure and edema. Accordingly, mortality rate in patients with excessive fat accumulation was significantly higher than in those without (P=0.007). The risk of technical failure was also increased with excessive fat gain. After adjusting for diabetes, obesity, and fluid status, it increased the incident risk of PD failure by 2.22-fold (95% CI 1.08–4.54). However, in the long-term group, fat gain did not impact on prognosis.

Conclusion

Excessive fat accumulation occurring primarily during the early period of PD was associated with baseline unhealthy metabolic profiles, higher mortality and PD failure rate independent of baseline obesity and fluid status.