Dataset Information

The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients.

ABSTRACT:

Background

Although hemodialysis (HD) adequacy, single-pool Kt/V_urea (spKt/V), is inversely correlated with body size, each is known to affect patient survival in the same direction. Therefore, we sought to examine the relationship between HD adequacy and mortality according to body mass index (BMI) in HD patients and explore a combination effect of BMI and HD adequacy on mortality risk.

Methods

We retrospectively reviewed patient data from the Korean Society of Nephrology registry, a nationwide database of medical records of HD patients, from January 2001 to June 2017. We included patients ?18?years old who were receiving maintenance HD. Patients were categorized into three groups according to baseline BMI (2). Baseline spKt/V was divided into six categories.

Results

Among 18,242 patients on HD, the median follow-up duration was 5.2 (IQR, 1.9-8.9) years. Cox regression analysis showed that, compared to the reference (spKt/V 1.2-1.4), lower and higher baseline spKt/V were associated with greater and lower risks for all-cause mortality, respectively. However, among patients with high BMI (n?=?5588), the association between higher spKt/V and lower all-cause mortality was attenuated in all adjusted models (P_interaction?ConclusionsThe association between spKt/V and mortality in HD patients may be modified by BMI.

SUBMITTER: Hong WP

PROVIDER: S-EPMC6805311 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients.

Hong Woong-Pyo WP Lee Yu-Ji YJ

BMC nephrology 20191022 1

<h4>Background</h4>Although hemodialysis (HD) adequacy, single-pool Kt/V<sub>urea</sub> (spKt/V), is inversely correlated with body size, each is known to affect patient survival in the same direction. Therefore, we sought to examine the relationship between HD adequacy and mortality according to body mass index (BMI) in HD patients and explore a combination effect of BMI and HD adequacy on mortality risk.<h4>Methods</h4>We retrospectively reviewed patient data from the Korean Society of Nephrol ...[more]

PMID: 31640580

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Project description:BackgroundPrevious studies have revealed that increased body mass index (BMI) is associated with decreased mortality among hemodialysis patients. However, few studies have dealt with the association between BMI and mortality among patients undergoing peritoneal dialysis (PD) and even fewer studies have focused on the Asian PD patients. The reported studies were often non-conclusive and some even yielded contradictory results. This paper, to our best knowledge, registers the first attempt to systematically review the current literature and summarize new results on the association between BMI and mortality among the Asian PD population.MethodA systematic literature review was performed in Medline and EMBASE to identify relevant cohort studies on all-cause and cardiovascular disease (CVD) mortality stratified by BMI categories tailored to Asians among the Asian PD population. We meta-analyzed individual results based on a random effect model, strictly complying with Preferred Reporting Items for Systematic Reviews and Meta-analysis.ResultsThe paper reviews seven cohort studies with a total of 3,610 Asian PD patients. Obese group (BMI = 25-29.9 kg/m2) was associated with higher risk of all-cause mortality (HR = 1.46, 95%CI [1.07-1.98]; p = 0.02) and CVD mortality (HR = 2.01, 95%CI [1.14-3.54]; p = 0.02), compared to the normal group (BMI = 18.5-22.9 kg/m2). The underweight group (BMI<18.5kg/m2) was also associated with an elevated risk of all-cause mortality (HR = 2.11, 95%CI [1.46-3.07]; p<0.001). No significant associations between BMI with all-cause mortality were found among the overweight group (23-24.9 kg/m2) (HR = 1.00, 95%CI [0.76-1.32]; p = 0.9). The association between BMI and CVD mortality risk among the underweight and overweight groups was found nonsignificant (p = 0.5 and 0.6 respectively).ConclusionObesity is associated with increased mortality in Asian PD patients. The study indicates a "V-shaped" trend in the association between BMI and mortality in these patients.

Dataset Information

The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients.

Background

Methods

Results

Publications

The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients.

Similar Datasets

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