Abstract: FR-PO1097
BMI Differences in Patients on Peritoneal Dialysis: A Weighty Insight
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Alam, Mahza, Kaiser Foundation Hospitals, Oakland, California, United States
- Lapasia, Jessica B., Kaiser Permanente San Francisco Medical Center, San Francisco, California, United States
Background
The prevalence of obesity among patients with end stage kidney disease (ESKD) has increased substantially, resulting in a growing number of patients that require renal replacement therapy. Prior studies have shown rising obesity rates among both hemodialysis (HD) and peritoneal dialysis patients, for example an increase from 17.4% to 24.6% in peritoneal dialysis (PD) in a region of Spain over the last decade (Quero 2020). PD is generally considered suboptimal for patients with higher body mass index due to concerns about risk of infection, reduced solute and fluid removal and higher rates of transfer to hemodialysis (Obi 2017). Therefore, PD is often considered a contraindication in patients with a higher BMI. We sought to evaluate the association between obesity and clinical outcomes among patients receiving PD.
Methods
We conducted a retrospective analysis of Kaiser Permanente Northern California internal PD units between 2015 to 2024. The study cohort included a total of 937 patients with 780 patients in BMI<35 group and 157 patients in BMI ≥35 group. Primary outcomes were length of time on PD, transfer to hemodialysis, dialysis adequacy, episode of peritonitis, and mortality.
Results
There was no statistical difference in terms of days on peritoneal dialysis between the groups (p value 0.208). The mean Kt/V for BMI<35 was 2.07 and 2.04 for BMI ≥35 (p value of 0.4). The average episodes of peritonitis was not statistically significant (p value 0.727) between the cohorts. We did not find differences in mortality rate at 30 days, 1 year or cumulative follow up.
Conclusion
Preliminary findings suggest that patients with BM≥35 had similar outcomes including rates of peritonitis, dialysis adequacy and mortality compared to those patients with BMI <35. PD offers several advantages over hemodialysis, including better preservation of residual renal function, higher patient scores on kidney disease quality of life (KDQOL) surveys, and overall flexibility for the patient. These results support the expanded use of PD for patients with higher BMI.