Abstract: FR-PO444
Impact of Obesity on Peritoneal Dialysis Outcomes: A Nationwide Inpatient Sample Analysis
Session Information
- Home Dialysis - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Suppadungsuk, Supawadee, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Kaewput, Wisit, Phramongkutklao College of Medicine, Bangkok, Thailand
- Tangpanithandee, Supawit, Chakri Naruebodin Medical Institute, Bang Phli, Samut Prakan, Thailand
- Davis, Paul W., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Cheungpasitporn, Wisit, Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background
Obesity can pose a significant challenge for performing peritoneal dialysis (PD) in end-stage kidney disease (ESKD) patients. This study aimed to assess the impact of obesity on in-hospital treatments, outcomes, and resource utilization in hospitalized ESKD patients receiving PD.
Methods
This study was conducted using the National Inpatient Sample to identify hospitalized ESKD patients receiving PD from the years 2003 to 2018. The in-hospital treatments, outcomes, and resource utilization were compared between obese and non-obese patients, adjusting for age, sex, race, year of hospitalization, and comorbidities.
Results
A total of 100,523 hospitalized ESKD patients receiving PD were included in the analysis. Of these, 9,890 (9.8%) had an obesity diagnosis. In the adjusted analysis, obese patients had a higher need for procedures for PD catheter adjustment or removal (OR 1.29; 95% CI 1.16-1.43), hemodialysis (OR 1.28; 95% CI 1.19-1.38), and mechanical ventilation (OR 1.29; 95% CI 1.16-1.44), compared to non-obese patients. Obesity was significantly associated with higher risk of PD peritonitis (OR 1.12; 95% CI 1.06-1.19) and fluid overload (OR 1.34; 95% CI 1.23-1.45) but lower in-hospital mortality (OR 0.84; 95% CI 0.73-0.96). No significant differences were observed in the length of hospital stay or hospitalization costs between the two groups.
Conclusion
Among hospitalized ESKD patients receiving PD, obesity was associated with higher PD-related complications but lower mortality. This suggests that while obesity may complicate the management of hospitalized ESKD patients on PD, it does not necessarily translate to increased mortality or healthcare expenses.
| Univariable analysis | p-value | Multivariable analysis | p-value | |
| PD catheter adjustment | 1.24 (1.12-1.37) | <0.001 | 1.29 (1.16-1.43) | <0.001 |
| Hemodialysis | 1.17 (1.09-1.25) | <0.001 | 1.28 (1.19-1.38) | <0.001 |
| Mechanical ventilator | 1.23 (1.11-1.36) | <0.001 | 1.29 (1.16-1.44) | <0.001 |
| PD peritonitis | 1.14 (1.08-1.21) | <0.001 | 1.12 (1.06-1.19) | <0.001 |
| PD mechanical complication | 1.00 (0.84-1.18) | 0.985 | 0.94 (0.80-1.12) | 0.52 |
| Hyperkalemia | 1.19 (1.11-1.27) | <0.001 | 1.06 (0.99-1.14) | 0.10 |
| Metabolic acidosis | 1.24 (1.15-1.33) | <0.001 | 1.07 (0.99-1.16) | 0.07 |
| Volume overload | 1.53 (1.41-1.65) | <0.001 | 1.34 (1.23-1.45) | <0.001 |
| Sepsis | 1.14 (1.08-1.22) | <0.001 | 1.06 (1.00-1.13) | 0.06 |
| Ventricular arrhythmia/cardiac arrest | 1.07 (0.92-1.25) | 0.354 | 0.99 (0.85-1.16) | 0.94 |
| In hospital mortality | 0.67 (0.58-0.76) | <0.001 | 0.84 (0.73-0.96) | 0.01 |
| Length of hospital stay (days) | -0.14 (-0.31, 0.02) | 0.08 | 0.11 (-0.06, 0.29) | 0.20 |