Abstract: TH-PO825

Change in Body Mass Index and Subsequent Risk of Hospitalization in Elderly Hemodialysis Patients: The Japanese Dialysis Outcome and Practice Patterns Study (J-DOPPS)

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Sumida, Keiichi, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
  • Yamamoto, Shungo, Kyoto University, KYOTO, Japan
  • Akizawa, Tadao, Showa University School of Medicine, Tokyo, Japan
  • Fukuhara, Shunichi, Kyoto University, KYOTO, Japan
  • Fukuma, Shingo, Kyoto University, KYOTO, Japan
Background

Short-term weight gains and losses are associated with lower and higher mortality risk, respectively, in patients on hemodialysis (HD). However, little is known about their association with the risk of subsequent hospitalization.

Methods

In a prospective cohort of 1,804 HD patients aged ≥65 years enrolled in the J-DOPPS phases 3 (2005–2008) and 4 (2009–2011), we examined the associations of changes in body mass index (BMI) over a 4-month baseline period (<-3, -3-<-1, -1-<1 [reference], 1-<3, and ≥3%) with subsequent risk of all-cause, cardiovascular (CV), and non-CV hospitalizations, respectively, using Cox models with adjustment for potential confounders.

Results

During a median follow-up of 1.2 years, there were 1,027 incident hospitalizations for any cause. There was an L-shaped association between BMI change and all-cause hospitalization (Figure). The adjusted HRs (95% CI) of all-cause hospitalization associated with BMI changes of <-3, -3-<-1, 1-<3, and ≥3% (vs. -1-<1%) were 1.30 (1.04-1.63), 1.23 (0.99-1.52), 1.04 (0.84-1.30), and 1.13 (0.86-1.49), respectively. Qualitatively similar associations were present for non-CV hospitalization (corresponding HRs [95% CI] were 1.33 [1.04-1.69], 1.24 [0.98-1.56], 1.07 [0.85-1.35], and 1.14 [0.84-1.56], respectively), but not for CV hospitalization (corresponding HRs [95% CI] were 1.23 [0.65-2.33], 1.10 [0.69-1.75], 0.87 [0.51-1.49], and 1.03 [0.46-2.33], respectively).

Conclusion

Decreases in BMI over a relatively short-term period were independently associated with higher risk of subsequent hospitalization, particularly non-CV hospitalization, among elderly HD patients.