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Objective: The nutritional status of patients on peritoneal dialysis PD is influenced by patient- and disease-related factors and lifestyle. Design and Methods: In this observational, international cohort study with longitudinal follow-up of 1, incident PD patients, the association of PD prescription with body composition was analyzed by using the linear mixed models, and the association of body composition with death and change to hemodialysis HD by means of a competing risk analysis combined with a spline analysis.

Body composition was regularly assessed with the body composition monitor, a device applying bioimpedance spectroscopy. Results: Age, time on PD, and the use of hypertonic and polyglucose solutions were significantly associated with a decrease in lean tissue index LTI and an increase in fat tissue index FTI over time.

Competing risk analysis revealed a U -shaped association of body mass index BMI with the subdistributional hazard ratio HR for risk of death.

High FTI was associated with a higher subdistributional HR when compared with the median as a reference. Subdistributional HR for risk of change to HD was not associated with any of the body composition parameters. The use of polyglucose or hypertonic PD solutions was predictive of an increased probability of change to HD, and the use of biocompatible solutions was predictive of a decreased probability of change to HD.