Document Detail


Association between body mass and mortality in maintenance hemodialysis patients.
MedLine Citation:
PMID:  20649761     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A total of 959 Taiwanese patients undergoing maintenance hemodialysis-102 underweight (BMI < 18.5 kg/m(2)), 492 normal weight (BMI 18.5-22.9 kg/m(2)), 187 overweight (BMI 23.0-24.9 kg/m(2)), and 178 obese (BMI >or= 25 kg/m(2)) were recruited into this three-year, multicenter longitudinal study. It was found initially that the underweight group had more females, longer hemodialysis durations, less use of a biocompatible membrane (BCM) dialyzer, higher erythropoietin doses and Kt/V(urea), and lower white blood cell counts, hemoglobin, serum creatinine and phosphate, and high sensitivity C-reactive protein (hsCRP) than other groups (P < 0.001). Furthermore, a chi(2)-test demonstrated that underweight patients had poorer nutrition (P = 0.023), but less systemic inflammation (P < 0.001) than other groups. A stepwise multiple linear regression analysis established that age, sex, diabetes mellitus, hemodialysis duration, use of BCM dialyzer, Kt/V(urea), creatinine, high-density lipoprotein cholesterol, and hsCRP were significant risk factors associated with BMI (P < 0.001-0.002). After three years, 149 (15.5%) patients had died, including 22 of 102 (21.6%) underweight patients, 64 of 492 (13.0%) normal weight patients, 38 of 187 (20.3%) overweight patients, and 25 of 178 (15.5%) obese patients. The primary causes of mortality were cardiovascular (52.3%) and infection (39.6%). A multivariate Cox regression analysis revealed that age, diabetes mellitus, BMI, albumin, hsCRP, and cardiothoracic ratio were significant risk factors associated with all-cause mortality over three years (P < 0.001-0.022). Finally, Kaplan-Meier analysis confirmed that underweight patients suffer higher mortality than other groups (Log rank, P = 0.0392); therefore, the data have demonstrated a survival disadvantage of low BMI in Taiwanese patients undergoing maintenance hemodialysis.
Authors:
Tzung-Hai Yen; Ja-Liang Lin; Dan-Tzu Lin-Tan; Ching-Wei Hsu
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  14     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  400-8     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan. m19570@adm.cgmh.org.tw
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Mass Index*
Cardiovascular Diseases / etiology,  mortality
Female
Humans
Infection / etiology,  mortality
Kaplan-Meiers Estimate
Kidney Failure, Chronic / therapy*
Linear Models
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Prospective Studies
Renal Dialysis / mortality*
Risk Factors
Taiwan
Thinness / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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