Full title
Authors
Sohail Abdul Salim, Yougandhar Akula, Swetha Kandhuri, Sabahat Afshan, Lajos Zsom, Mehul P. Dixit, Tibor Fülöp
Abstract
Peritoneal dialysis (PD) obviates the need for temporary vascular access in end-stage renal disease; however, extremely heavy weight has been viewed as a relative contraindication to PD.We performed a cross-sectional review of multiple clinical and laboratory variables for 75 current or past PD patients (vintage > 6 months), comparing dialysis adequacy parameters for those with a large body weight (>100 kg, LWS group) and with a normal body weight (<75 kg, NWS group).In the LWS group (n = 17), mean weight was 117.2 ± 15.7 kg, and mean body mass index (BMI) was 37.2 ± 6.3 kg/m(2); in the NWS group (n = 33), mean weight was 63.2 ± 9.2 kg, and mean BMI was 25.3 ± 4.5 kg/m(2). Despite the marked differences in weight and BMI between the groups (both p < 0.0001), achieved Kt/V was adequate, although marginally less, in large subjects (1.96 ± 0.29 for the LWS group vs. 2.22 ± 0.47 for the NWS group, p = 0.022), and weekly global creatinine clearance was significantly better in the LWS group (92.5 ± 43.5 L/1.73 m(2) vs. 62.2 ± 27.5 L/1.73 m(2), p = 0.016). The total daily exchange volume was approximately 30% higher in the LWS group (12.8 ± 2.5 L vs. 9.9 ± 2.2 L, p < 0.0001). Residual creatinine clearance (p = 0.224) and residual urine output (p = 0.125) were similar and did not seem to influence the results. Compared with their LWS counterparts, members of the NWS group were more likely to have higher iron saturation (p = 0.053) and serum ferritin (p = 0.004), but lower achieved hemoglobin (p = 0.055).Successful PD is feasible in larger-weight individuals; however, given the retrospective nature of the present study, prospective trials are needed to confirm that observation.
