Body roundness Index on the clinical outcome of peritoneal dialysis patients: Analysis of two cohorts

Background Central obesity is common among patients undergoing peritoneal dialysis (PD) and may have important metabolic consequences. The body roundness index (BRI) is a convenient anthropometric measurement that represents central adiposity and visceral fat. However, its prognostic value in PD patients has not yet been explored. Method We conducted a retrospective study involving two cohorts of PD patients: an exploratory cohort of 249 prevalent PD patients and a validation cohort of 162 incident ones. In addition to BRI, we performed bioimpedance spectroscopy and other routine clinical and biochemical tests. Outcome measures included patient survival, rate of alive and remained on PD, peritonitis-free survival, and hospitalization rates. Results In the exploratory cohort, the baseline BRI was an independent risk factor for all-cause mortality, with an adjusted hazard ratio of 1.346 (95% CI: 1.094 to 1.655, p = 0.005), and for rate of alive and remained on PD, with an adjusted hazard ratio of 1.279 (95% CI: 1.079 to 1.517, p = 0.004). A high BRI was also associated with a higher frequency of hospitalizations (p = 0.001) and longer hospital stays (p = 0.002). In the validation cohort, baseline BRI was also associated with patient survival by univariable Cox regression analysis, but the result became insignificant after adjusting for confounding clinical factors by multi-variable Cox regression. Conclusion A high BRI is associated with increased rates of all-cause mortality and hospitalization. However, the results from the exploratory and validation cohorts were somewhat inconsistent, indicating the necessity for further research to validate our findings. Index Words: kidney failure; obesity; cardiovascular disease