Abstract: TH-PO808

Survival in Patients on Hemodialysis: Effect of Sex According to Body Mass Index and Creatinine

Session Information

Category: Dialysis

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

Authors

  • Lee, Jong-Hak, Daegu Fatima Hospital, Daegu, Korea (the Republic of)
  • Lim, Jeong hoon, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Han, Man-hoon, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Jung, Hee-Yeon, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Choi, Ji-Young, Kyungpook National University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Sun-Hee, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Kim, Chan-Duck, Kyungpook University Hospital, Daegu, Korea (the Republic of)
  • Cho, Jang-Hee, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Kim, Yong-Lim, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
Background

The association of a higher body mass index (BMI) with better survival is a well-known “obesity paradox” in patients on hemodialysis (HD). However, men and women have different body compositions, which could impact the effect of BMI on mortality. We investigated the effect of sex on the obesity-mortality relationship in Korean patients on HD.

Methods

This study included 2,833 maintenance patients on HD from a multicenter prospective cohort study in Korea (NCT00931970). The relationship between categorized BMI and sex-specific all-cause mortality was analyzed by an adjusted Cox proportional hazard model with restricted cubic spline analyses. We also investigated the effect of changes in BMI over 12 months and serum creatinine level on survival in male and female patients on HD.

Results

The mean BMI was 22.6 ± 3.3 kg/m2 and the mean follow up duration was 24.2 ± 3.4 months. The patients with the highest quintile of BMI (≥25.1 kg/m2) showed lower mortality (Hazard ratio [HR]=0.63, 95% confidence interval [CI]=0.42-0.95, P=0.026) compared with those with the reference BMI quintile. When analyzed by sex, male patients with a BMI over 25.1 kg/m2 had lower mortality risk (HR=0.43, 95% CI=0.25-0.75, P=0.003); however, no significant difference was found in female patients. Increased BMI after 12 months and high serum creatinine were associated with better survival only in male patients on HD.

Conclusion

BMI could be used as a risk factor for mortality in male patients on HD. However, the mortality of female patients on HD was not related with baseline and follow-up BMI. This suggests that BMI is a good surrogate marker of lean body composition, especially in male patients on HD.

Funding

  • Government Support - Non-U.S.