Does body mass index affect survival and technique failure in patients undergoing peritoneal dialysis?

OBJECTIVE To investigate effect of body mass index (BMI) on survival and technique failure in patients undergoing peritoneal dialysis (PD). METHODS In this retrospective study three hundred ninety-two consecutive patients undergoing peritoneal dialysis from September 1995 to January 2013 were included. Median PD duration was 53 (range: 4-189) months. Clinical outcomes were mortality and technique failure. Technique failure was defined as transfer to hemodialysis (HD) due to peritonitis, ultrafiltration failure, inadequate dialysis, exit-site and/or tunnel infection, and mechanical problems. Deaths within 3 months after transferring to HD were accepted as PD-related mortalities. The patient and technique survival rates were estimated using the Kaplan-Meier method. Mortality risks were analyzed using the multivariate Cox regression model in which we included (in a backward-wald manner) all the significant variables from the univariate analysis. RESULTS There were 164 (41.8%) deaths. Forty-six (11.7%) patients underwent renal transplantation whereas 132 (33.7%) patients were transferred to HD. The multivariate Cox regression analysis found that the patient survival rates were significantly associated with age, BMI, baseline serum creatinine and albumin levels, and total Kt/Vurea. All variables as potential risk factors for the patient survival were also assessed for technique survival in univariate analysis and technique survival rates were significantly associated only with BMI (p: 0.015). CONCLUSION BMI was associated with unfavorable patient survival in PD patients.