High body mass index (BMI) does not adversely affect cardiovascular (CV) and all-cause mortality in hemodialysis patients
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:205A 1997
The effect of body mass index on mortality were determined in 5,438 HD patients who received dialysis through Dialysis Clinics Incorporated. Patients were followed from 1992 to 1995 and the data were analyzed by three Cox proportional hazards models, one for cardiovascular mortality, one for non-cardiovascular mortality, and one for all-cause mortality. The analyses were adjusted for age, gender, ethnicity, presence or absence of diabetes, predialysis blood pressure, use or nonuse of antihypertensive medications, serum albumin, and years on dialysis.
In all 3 models of mortality, patients with a BMI of < 20 had an increased risk of mortality compared to patients with higher levels of BMI. Patients in the high BMI group, that is those with a BMI > 35, did not have an increased risk of mortality, and the mortality rates were similar to that of patients with BMIs between 25 to 29 and 30 to 34. For all-cause mortality, the relative risk of mortality was 0.88 (CI-0.77 to 1.01) for BMI < 20; 0.48 (CI-0.41 to 0.56) for BMI 25-29; 0.55 (CI-0.44 to 0.68) for BMI 30-34; and 0.47 (CI-0.37 to 0.61) for BMI > 35. The relative risk and confidence intervals for cardiovascular and non-cardiovascular causes of mortality were similar to that for all-cause mortality. Finally, there was only a very modest association between serum albumin levels and BMI with an r value of 0.02, which was nonsignificant.
Comment: The authors conclude that a high body mass index does not appear to adversely affect the survival of hemodialysis patients. Michael V. Rocco, M.D., Bowman Gray School of Medicine
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ASN 30th Annual Meeting, San Antonio
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