626 Obesity Does Not Affect Peritoneal Dialysis Patency but Is Adversely Associated with PD Peritonitis

Aim Obesity is associated with adverse outcomes following surgery. Peritoneal dialysis (PD), a form of renal replacement therapy for patients with end-stage renal failure, requires the insertion of a PD catheter. The aims of this study were to evaluate the impact of body mass index (BMI) on outcomes following PD catheter insertion. Method Data were collected retrospectively from a prospectively maintained database for all patients who underwent PD catheter insertion within a single health board between 01/01/2016 and 10/07/2023. Primary outcomes were PD catheter patency (defined by successful PD commencement), need for PD catheter repositioning, and PD peritonitis. Patients were followed up for a median of 24 months (range 17 – 31 months). The effect of BMI and various patient factors was analysed using univariate and multivariate regression analyses. Results 365 patients had a PD catheter inserted over the 7-year period. 276 (75.6%) patients successfully initiated PD, 70 (19.2%) required PD catheter repositioning and 143 (39.2%) experienced peritonitis. When controlling for other variables, BMI did not affect patency or repositioning however patients with a BMI of 30 or more experienced increased episodes of peritonitis. Diabetes was also found to increase the risk of repositioning and peritonitis 2.95-fold (p=0.02) and 1.45-fold (p=0.04) respectively. Conclusions Increased BMI is associated with increased episodes of peritonitis but does not affect patency or repositioning. Diabetes was found to be an adverse risk factor for repositioning and peritonitis. A targeted approach in diabetic and obese patients may be required to reduce the risk of PD peritonitis.