Increase of Intra-Abdominal 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 (CAPD). DESIGN: Prospective study. Computed tomography (CT) and dual energy x-ray absorptiometry (DEXA) were used for determination of body composition at commencement of CAPD, and after a mean of 7.2 months of dialysis 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 MEASURES: Siemens Somatom HiQ (Erlangen, Germany) was used for CT of the abdomen 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, Madison, WI, U.S.A.) and expressed as percentage of total body weight (FA%). 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 increase was predominantly seen in male patients (p = 0.007). The FAT% changed from 27.8% to 30.9% (p = 0.25), without difference between sexes. CONCLUSION: 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 partially explained.