INCREASE OF INTRAABDOMINAL FAT IN PATIENTS TREATED WITH CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Objective: To evaluate changes in amount and distribution of body fat in patients treated with continuous ambulatory peritoneal dialysis (CA PD). Design: Prospective study. Computed tomography (CT) and dual ener gy x-ray absorptiometry (DEXA) were used for determination of body com position at commencement of CAPD, and after a mean of 7.2 months of di alysis treatment. Setting: CAPD unit at an academic teaching hospital. Patients: The study included 19 consecutive patients who started CAPD during a 15-month time frame. Of these 19 patients, 12 (8 males) with a mean initial age of 60 years completed the study. Main Outcome Meas ures: Siemens Somatom HiQ (Erlangen, Germany) was used for CT of the a bdomen and of the right thigh. Fat and muscle areas were expressed as square centimeters. The proportion of total fat mass was determined by body composition analysis using DEXA (DPX-L densitometer) (Lunar, Mad ison, WI, U.S.A.) and expressed as percentage of total body weight (FA T%). Results: Body weight changed from 67.1 to 68.4 kg (p = 0.20), and the intra-abdominal fat area increased 22.8% (p = 0.02). This increas e was predominantly seen in male patients (p = 0.007). The FAT% change d from 27.8% to 30.9% (p = 0.25), without difference between sexes. Co nclusion: The increase of intra-abdominal fat found in this study may suggest a mechanism by which the established risk for CAPD patients to develop cardiovascular morbidity and mortality may be at least partia lly explained.