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Introduction <p>Increased intraabdominal fat volume (IAFV) is associated with systemic inflammation and various cardiometabolic diseases. However, the clinical implication of IAFV in patients on peritoneal dialysis (PD) is unclear. In addition, the association of intraabdominal fat-free volume (IAFFV), which could mainly reflect the volume of visceral organs that serve as a potential source of inflammatory uremic toxins, with PD-associated clinical outcomes remains unknown. </p> Methods <p>We retrospectively measured IAFV and IAFFV in the 108 patients on PD using abdominal computed tomography at initiation of PD. The participants were followed up until PD cessation, death, or study completion. We investigated the relationships between IAFV and IAFFV and the risks of peritonitis and PD discontinuation (defined by a composite endpoint of death or transfer to hemodialysis).</p> Results <p>The median follow-up period was 46 (interquartile range 24–82) months. The baseline obesity-related traits significantly (<i>P</i> &lt; 0.05) differed between high-IAFV (≥ 2935 cm<sup>3</sup>) and low-IAFV (&lt; 2935 cm<sup>3</sup>) groups. However, the log-rank tests found no differences in the incidence of peritonitis and PD discontinuation between groups. In contrast, both peritonitis-free survival and time on PD therapy were shorter in high-IAFFV (≥ 4796 cm<sup>3</sup>) group than in low-IAFFV (&lt; 4796 cm<sup>3</sup>) group (all <i>P</i> &lt; 0.05). In the Cox regression models, IAFFV remained a strong risk factor for peritonitis even after adjusting for confounders (hazard ratio: 2.16, 95% confidence interval: 1.07–4.38).</p> Conclusions <p>We demonstrate that IAFFV is an independent risk factor of peritonitis in patients o nPD. Additional studies are needed to identify specific intraabdominal component(s) involved in the pathogenesis of PD-associated adverse events.</p>

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Intraabdominal fat-free volume, but not fat volume, predicts the development of peritonitis in patients on peritoneal dialysis: a retrospective cohort study

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  • 发表日期：

    2025年6月29日

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  • Ryunosuke Mitsuno,
  • Kohkichi Morimoto,
  • Kenji Kaneko,
  • Daiki Kojima,
  • Toshifumi Nakamura,
  • Takashin Nakayama,
  • Eriko Yoshida Hama,
  • Shun Tonomura,
  • Yoshitake Yamada,
  • Masahiro Jinzaki,
  • Kiyotaka Uchiyama,
  • Naoki Washida,
  • Takeshi Kanda,
  • Tatsuhiko Azegami,
  • Tadashi Yoshida,
  • Jun Yoshino,
  • Kaori Hayashi

摘要

Introduction

Increased intraabdominal fat volume (IAFV) is associated with systemic inflammation and various cardiometabolic diseases. However, the clinical implication of IAFV in patients on peritoneal dialysis (PD) is unclear. In addition, the association of intraabdominal fat-free volume (IAFFV), which could mainly reflect the volume of visceral organs that serve as a potential source of inflammatory uremic toxins, with PD-associated clinical outcomes remains unknown.

Methods

We retrospectively measured IAFV and IAFFV in the 108 patients on PD using abdominal computed tomography at initiation of PD. The participants were followed up until PD cessation, death, or study completion. We investigated the relationships between IAFV and IAFFV and the risks of peritonitis and PD discontinuation (defined by a composite endpoint of death or transfer to hemodialysis).

Results

The median follow-up period was 46 (interquartile range 24–82) months. The baseline obesity-related traits significantly (P < 0.05) differed between high-IAFV (≥ 2935 cm3) and low-IAFV (< 2935 cm3) groups. However, the log-rank tests found no differences in the incidence of peritonitis and PD discontinuation between groups. In contrast, both peritonitis-free survival and time on PD therapy were shorter in high-IAFFV (≥ 4796 cm3) group than in low-IAFFV (< 4796 cm3) group (all P < 0.05). In the Cox regression models, IAFFV remained a strong risk factor for peritonitis even after adjusting for confounders (hazard ratio: 2.16, 95% confidence interval: 1.07–4.38).

Conclusions

We demonstrate that IAFFV is an independent risk factor of peritonitis in patients o nPD. Additional studies are needed to identify specific intraabdominal component(s) involved in the pathogenesis of PD-associated adverse events.