Peritoneal Dialysis in Class 2-3 Obesity-A Single-Center Experience

Extreme obesity may hamper successful peritoneal dialysis (PD) delivery. Among our PD patients, we have identified 15 markedly obese (class 2-3 obesity: body mass index [BMI] ≥35 kg/m2) and 20 lean (BMI: 20-25 kg/m2) dialysis patients and reviewed multiple clinical, laboratory and dialysis-related parameters. Extreme outliers of obesity (BMI > 40; 6 subjects) received detailed review. Although weight (P < 0.0001) and BMI (P < 0.0001) differed significantly, weekly Kt/V (obese versus lean: 2.05 ± 0.51 versus 2 ± 0.36), creatinine clearance (86.8 ± 44.8 versus 70 ± 30.4 L/1.73 m2) or residual renal functions were not statistically different. Total daily PD exchange volumes were similar (11.2 ± 2.5 L versus 10.4 ± 2.5 L, P = 0.378). Serum albumin, calcium, phosphorus, hemoglobin and parathyroid hormone levels did not differ, either. Analogous results have been obtained for extremely obese subjects (BMI 44.3 ± 4.2 kg/m2; range: 40.2-51.6). Our study shows only limited effect of class ≥2 obesity for successful PD in this predominantly African American cohort.