WAIST CIRCUMFERENCE AS A PREDICTOR OF MORTALITY IN PERITONEAL DIALYSIS PATIENTS

Abstract

Body fat gain is a common finding among peritoneal dialysis (PD) patients, and the accumulation of adipose tissue occurs predominantly in the abdominal area. Waist circumference (WC) is a reliable marker of abdominal obesity and its association with worse outcomes has been demonstrated in nondialysis and hemodialysis patients. Herein, we aimed at investigating whether WC measurements as well as the overtime changes in WC were able to predict mortality in PD patients. This prospective study included 109 prevalent PD patients [57% male, age 52±16 years, 32% diabetics, 48% BMI ≥25 kg/m2]. WC was measured at umbilicus level (empty abdominal cavity) at baseline and after 6 months. WC measurements >88 cm for women and >102 cm for men were considered as increased. Nutritional status and laboratory parameters were also evaluated. Mortality was registered during a period of 48 months. At baseline, increased WC was observed in 55.3% of women and 22.6% of men. A total of 60.5% of the PD patients increased WC after 6 months. Patients who died during the follow-up (nonsurvival group, n=27) were older than the survivor group. A significant increase in WC was observed in the former group. In the cox regression analysis adjusting for sex, age, length on PD, diabetes, BMI, serum albumin and C-reactive protein, increased WC at baseline was associated with mortality. Adjusting for confounders, 6-month increase in WC was also a predictor of mortality in these patients. Increased WC at baseline and overtime changes in WC were both associated with mortality in PD patients.