NEITHER SIZE NOR WEIGHT PREDICTS SURVIVAL IN PERITONEAL-DIALYSIS PATIENTS

Objective: To determine if patient size or weight at the start of PD i nfluences patient or technique survival. Design: A prospective cohort study of adult PD patients. Setting: A university and a Veterans Admin istration outpatient dialysis unit. Patients: 343 adults patients with 660 years on PD enrolled from 1979 to 1995.Main Outcome Measures: Pat ient survival (censoring for transplant, 60 days post-transfer to hemo dialysis, and end of study)and technique survival (censoring for death , transplant, or end of the study) for patients as grouped by weight ( less than or equal to 64 kg vs. >64 kg or less than or equal to 82.7 k g vs. >82.7 kg) or BSA (less than or equal to 2.0 m(2) vs >2.0 m(2)). Results: Patient survival was 86.3% at one year, 77.0% at two years, 6 5.2% 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 signifi cantly different for patients as grouped by weight or BSA. Using Cox p roportional hazards model, age, diabetes, peritonitis rate, and albumi n at the start of PD 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 p atients on PD. Size alone should not preclude patients from PD.