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Time-varying effects of body mass index on mortality among hemodialysis patients: Results from a nationwide Korean registry
Kidney Research and Clinical Practice ; : 90-99, 2019.
Artículo en Inglés | WPRIM | ID: wpr-758971
ABSTRACT

BACKGROUND:

Unlike patterns observed in the general population, obesity is associated with better survival among hemodialysis patients, which could be explained by reverse causation or illness-related weight loss. However, the time-varying effect of body mass index (BMI) on hemodialysis survival has not been investigated. Therefore, this study investigated the time-varying effect of BMI on mortality after starting hemodialysis.

METHODS:

In the present study, we examined Korean Society of Nephrology data from 16,069 adult patients who started hemodialysis during or after the year 2000. Complete survival data were obtained from Statistics Korea. Survival analysis was performed using Cox regression and a non-proportional hazard fractional polynomial model.

RESULTS:

During the median follow-up of 8.6 years, 9,272 patients (57.7%) died. Compared to individuals with normal BMI (18.5–24.9 kg/m²), the underweight group (< 18.5 kg/m²) had a higer mortality hazard ratio (HR, 1.292; 95% confidence interval [CI], 1.203–1.387; P < 0.001) and the overweight group (25.0–29.9 kg/m²) had a lower mortality HR (0.904; 95% CI, 0.829–0.985; P = 0.022). The underweight group had increasing HRs during the first 3 to 7 years after starting hemodialysis, which varied according to age group. The young obese group (< 40 years old) had a U-shaped temporal trend in their mortality HRs, which reflected increased mortality after 7 years.

CONCLUSION:

The obese hemodialysis group had better survival during the early post-dialysis period, although the beneficial effect of obesity disappeared 7 years after starting hemodialysis. The young obese group also had an increased mortality HR after 7 years.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Delgadez / Pérdida de Peso / Índice de Masa Corporal / Estudios de Seguimiento / Mortalidad / Modelos Estadísticos / Diálisis Renal / Sobrepeso / Corea (Geográfico) / Nefrología Tipo de estudio: Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Adulto / Humanos País/Región como asunto: Asia Idioma: Inglés Revista: Kidney Research and Clinical Practice Año: 2019 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Delgadez / Pérdida de Peso / Índice de Masa Corporal / Estudios de Seguimiento / Mortalidad / Modelos Estadísticos / Diálisis Renal / Sobrepeso / Corea (Geográfico) / Nefrología Tipo de estudio: Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Adulto / Humanos País/Región como asunto: Asia Idioma: Inglés Revista: Kidney Research and Clinical Practice Año: 2019 Tipo del documento: Artículo