Neither Size Nor Weight Predicts Survival in Peritoneal Dialysis Patients

Abstract

Objective

To determine if patient size or weight at the start of PO influences patient or technique survival.

Design

A prospective cohort study of adult PO patients.

Setting

A university and a Veterans Administration outpatient dialysis unit.

Patients

343 adults patients with 660 years on PO enrolled from 1979 to 1995.

Main Outcome Measures

Patient survival (censoring for transplant, 60 days post -transfer to hemodialysis, and end of study) and technique survival (censoring for death, transplant, or end of the study) for patients as grouped by weight (≤ 64 kg vs. >64 kg or ≤82.7 kg vs. > 82.7 kg) or BSA (≤2.0 m2 vs >2.0 m2).

Results

Patient survival was 86.3% at one year, 77.0% at two years, 65.2% at three years, and 56.9% at 4 years. Technique survival was 84.9% at one year, 77.5% at two years, 63.5% at three years, and 58.3% at four years. The patient and technique survival curves were not significantly different for patients as grouped by weight or BSA. Using Cox proportional hazards model, age, diabetes, peritonitis rate, and albumin at the start of PO were independent predictors of patient survival, but BSA and weight were not. The only predictor of technique survival was the peritonitis rate. Larger patients had higher initial albumins, which may indicate better nutritional status that may offset the risk of underdialysis.

Conclusions

Large patients do as well as smaller patients on PO. Size alone should not preclude patients from PO.