Obesity is a risk factor for peritonitis in the Australian and New Zealand peritoneal dialysis patient populations

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dc.contributor.authorMcDonald, S.
dc.contributor.authorCollins, J.
dc.contributor.authorRumpsfeld, M.
dc.contributor.authorJohnson, D.
dc.date.issued2004
dc.description.abstract<h4>Objective</h4>The aim of the present investigation was to examine the association between body mass index (BMI) and peritonitis rates among incident peritoneal dialysis (PD) patients in a large cohort with long-term follow-up.<h4>Design</h4>Retrospective observational cohort study of the Australian and New Zealand PD patient population.<h4>Setting</h4>Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry.<h4>Participants</h4>The study included all incident adult patients (n = 10 709) who received PD in Australia and New Zealand in the 12-year period between 1 April 1991 and 31 March 2003. Patients were classified as obese (BMI > or = 30 kg/m2), overweight (BMI 25.0 - 29.9 kg/m2), normal weight (20 - 24.9 kg/m2), or underweight (< 20 kg/m2).<h4>Main measurements</h4>Time to first peritonitis and episodes of peritonitis per patient-year were recorded over the 12-year period.<h4>Results</h4>Higher BMI was associated with a shorter time to first peritonitis episode, independent of other risk factors [hazard ratio 1.08 for each 5-kg/m2 increase in BMI, 95% confidence interval (CI) 1.04 - 1.12, p < 0.001]. When peritonitis outcomes were analyzed as episodes of peritonitis per patient-year, these rates were significantly higher among patients with higher BMI: underweight 0.69 episodes/year (95% CI 0.66 - 0.73), normal weight 0.79 (95% CI 0.77 - 0.81), overweight 0.88 (95% CI 0.85 - 0.90), obese 1.06 (95% CI 1.02 - 1.09). Coronary artery disease and chronic lung disease were associated with both shorter time to first peritonitis and higher peritonitis rates, independently of these other factors. There was also a "vintage effect," with lower peritonitis rates seen among people who commenced dialysis in more recent years.<h4>Conclusions</h4>Higher BMI at the commencement of renal replacement therapy is a significant risk factor for peritonitis. The mechanisms for this remain undefined.
dc.identifier.citationPeritoneal Dialysis International, 2004; 24(4):340-346
dc.identifier.doi10.1177/089686080402400408
dc.identifier.issn0896-8608
dc.identifier.issn1718-4304
dc.identifier.orcidMcDonald, S. [0000-0001-6103-1386]
dc.identifier.urihttp://hdl.handle.net/2440/9978
dc.language.isoen
dc.publisherMultimed Inc
dc.source.urihttp://www.pdiconnect.com/content/24/4/340.abstract
dc.subjectHumans
dc.subjectPeritonitis
dc.subjectKidney Failure, Chronic
dc.subjectObesity
dc.subjectBody Mass Index
dc.subjectPeritoneal Dialysis
dc.subjectRegistries
dc.subjectRisk Factors
dc.subjectRetrospective Studies
dc.subjectFollow-Up Studies
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectAustralia
dc.subjectNew Zealand
dc.subjectFemale
dc.subjectMale
dc.titleObesity is a risk factor for peritonitis in the Australian and New Zealand peritoneal dialysis patient populations
dc.typeJournal article
pubs.publication-statusPublished

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