The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysis

A decreased body mass index (BMI) over time is associated with a poor prognosis for patients on hemodialysis. We aimed to examine whether this association also applies to patients with peritoneal dialysis (PD). BMI change was defined as the percentage change in the BMI between the time of PD cathete...

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Main Authors: Daiki Kojima, Naoki Washida, Kiyotaka Uchiyama, Eriko Yoshida Hama, Tomoki Nagasaka, Ei Kusahana, Takashin Nakayama, Kengo Nagashima, Yasunori Sato, Kohkichi Morimoto, Takeshi Kanda, Hiroshi Itoh
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2022.2163904
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author Daiki Kojima
Naoki Washida
Kiyotaka Uchiyama
Eriko Yoshida Hama
Tomoki Nagasaka
Ei Kusahana
Takashin Nakayama
Kengo Nagashima
Yasunori Sato
Kohkichi Morimoto
Takeshi Kanda
Hiroshi Itoh
author_facet Daiki Kojima
Naoki Washida
Kiyotaka Uchiyama
Eriko Yoshida Hama
Tomoki Nagasaka
Ei Kusahana
Takashin Nakayama
Kengo Nagashima
Yasunori Sato
Kohkichi Morimoto
Takeshi Kanda
Hiroshi Itoh
author_sort Daiki Kojima
collection DOAJ
description A decreased body mass index (BMI) over time is associated with a poor prognosis for patients on hemodialysis. We aimed to examine whether this association also applies to patients with peritoneal dialysis (PD). BMI change was defined as the percentage change in the BMI between the time of PD catheter insertion and six months after its insertion. The association between the BMI change and all-cause mortality or PD discontinuation from six months after PD catheter insertion until October 2021 was investigated. This retrospective cohort study included 122 patients (aged 61.1 ± 12.1 years; 90 males) who underwent PD catheter insertion between January 2008 and March 2020. The median follow-up period was 43.1 (21.2–78.8) months. The median six-month percentage change in the BMI was −2.14 (−5.56–1.84)%, and patients were categorized into tertiles based on their BMI changes. The fully-adjusted Cox regression analysis revealed a significantly higher rate of PD discontinuation or all-cause mortality (hazard ratio (HR): 2.48; 95%; confidence interval (CI): 1.41–4.37) in patients with the lowest tertile (T1, BMI change: < −4.13%) compared to patients with the middle tertile (T2, BMI change: −4.13%–0.67%). The risk was not significantly higher in patients with the highest tertile (T3, BMI change: >0.67%) than those in the T2 group (HR: 1.18; 95% CI: 0.66–2.11). A decreased BMI over time is independently associated with HD transfer or all-cause mortality among patients initiating PD, which highlights the importance of the 6-month BMI change as a novel prognostic marker.
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spelling doaj-art-349a57ed71a14e41b60b84c0a305c20e2025-08-20T02:16:11ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2022.2163904The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysisDaiki Kojima0Naoki Washida1Kiyotaka Uchiyama2Eriko Yoshida Hama3Tomoki Nagasaka4Ei Kusahana5Takashin Nakayama6Kengo Nagashima7Yasunori Sato8Kohkichi Morimoto9Takeshi Kanda10Hiroshi Itoh11Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Nephrology, International University of Health and Welfare Narita Hospital, Narita, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanBiostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, JapanBiostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, JapanApheresis and Dialysis Center, Keio University School of Medicine, Shinjuku, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanA decreased body mass index (BMI) over time is associated with a poor prognosis for patients on hemodialysis. We aimed to examine whether this association also applies to patients with peritoneal dialysis (PD). BMI change was defined as the percentage change in the BMI between the time of PD catheter insertion and six months after its insertion. The association between the BMI change and all-cause mortality or PD discontinuation from six months after PD catheter insertion until October 2021 was investigated. This retrospective cohort study included 122 patients (aged 61.1 ± 12.1 years; 90 males) who underwent PD catheter insertion between January 2008 and March 2020. The median follow-up period was 43.1 (21.2–78.8) months. The median six-month percentage change in the BMI was −2.14 (−5.56–1.84)%, and patients were categorized into tertiles based on their BMI changes. The fully-adjusted Cox regression analysis revealed a significantly higher rate of PD discontinuation or all-cause mortality (hazard ratio (HR): 2.48; 95%; confidence interval (CI): 1.41–4.37) in patients with the lowest tertile (T1, BMI change: < −4.13%) compared to patients with the middle tertile (T2, BMI change: −4.13%–0.67%). The risk was not significantly higher in patients with the highest tertile (T3, BMI change: >0.67%) than those in the T2 group (HR: 1.18; 95% CI: 0.66–2.11). A decreased BMI over time is independently associated with HD transfer or all-cause mortality among patients initiating PD, which highlights the importance of the 6-month BMI change as a novel prognostic marker.https://www.tandfonline.com/doi/10.1080/0886022X.2022.2163904Obesitysarcopeniafrailtymalnutritionperitonitisheart failure
spellingShingle Daiki Kojima
Naoki Washida
Kiyotaka Uchiyama
Eriko Yoshida Hama
Tomoki Nagasaka
Ei Kusahana
Takashin Nakayama
Kengo Nagashima
Yasunori Sato
Kohkichi Morimoto
Takeshi Kanda
Hiroshi Itoh
The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysis
Renal Failure
Obesity
sarcopenia
frailty
malnutrition
peritonitis
heart failure
title The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysis
title_full The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysis
title_fullStr The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysis
title_full_unstemmed The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysis
title_short The body mass index change is associated with death or hemodialysis transfer in Japanese patients initiating peritoneal dialysis
title_sort body mass index change is associated with death or hemodialysis transfer in japanese patients initiating peritoneal dialysis
topic Obesity
sarcopenia
frailty
malnutrition
peritonitis
heart failure
url https://www.tandfonline.com/doi/10.1080/0886022X.2022.2163904
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