Abstract: TH-PO456

Association between Body Mass Index and In-Hospital Mortality in Emergently Hospitalized Dialysis-Independent CKD Patients: A Nationwide Retrospective Cohort Study in Japan

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Kikuchi, Hiroaki, Tokyo Medical and Dental University, Tokyo, Japan
  • Sohara, Eisei, Tokyo Medical and Dental University, Tokyo, Japan
  • Okado, Tomokazu, Department of Nephrology, Tokyo medical and dental university, Tokyo, Japan
  • Uchida, Shinichi, Tokyo Medical and Dental University, Tokyo, Japan
  • Fushimi, Kiyohide, Tokyo Medical and Dental University, Tokyo, Japan
  • Rai, Tatemitsu, TOKYO MEDICAL & DENTAL UNIV, TOKYO, Japan
  • Kanda, Eiichiro, Tokyo Kyosai Hospital, Meguro, ToKyo, Japan
  • Ando, Fumiaki, Tokyo Medical and Dental University, Tokyo, Japan
  • Sato, Hidehiko, Department of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan
  • Isobe, Kiyoshi, Department of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan
  • Mori, Takayasu, Tokyo Medical and Dental University, Tokyo, Japan
  • Iimori, Soichiro, Department of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan
  • Nomura, Naohiro, Tokyo Medical and Dental University, Tokyo, Japan
  • Naito, Shotaro, Tokyo Medical and Dental University, Tokyo, Japan
Background

The relationship between high body mass index (BMI) and in-hospital mortality in emergently hospitalized dialysis-independent chronic kidney disease (DI-CKD) patients is unknown.

Methods

The study cohort was comprised of 7936 emergently hospitalized DI-CKD patients (stages 3–5) age 20-70 years old who were treated in hospitals participating in the Diagnosis Procedure Combination (DPC) system. Data for patients hospitalized from April 2015 to March 2016 were collected. Patients were classified by presence (n=2427) or absence (n= 5509) of inflammation (coexistence with malignancy and/or infectious diseases). Patients were divided into tertiles by BMI: group 1, low BMI (< 20.5 kg/m2); group 2, normal BMI (20.5-25.0 kg/m2); group 3, high BMI (> 25.0 kg/m2). Non-inflamed patients in BMI group 3 formed the reference group. The primary outcome was the occurrence of in-hospital death.

Results

Logistic regression analysis adjusted for baseline characteristics showed that among both inflamed and non-inflamed patients, group 1 was significantly associated with the highest risk of in-hospital mortality. For inflamed patients, the adjusted odds ratio (aOR) for group 1,2 and 3 were 3.62 [95% confidence interval (CI) (2.69, 4.86)], 2.88 (95% CI 2.13, 3.90), 2.34 (95% CI 1.68, 3.24), respectively. For non-inflamed patients, aOR for groups 1 and 2 were 2.00 (95% CI (1.51, 2.64), and 1.20 (95% CI 0.89, 1.62), respectively.

Conclusion

This study suggests that high BMI leads to better in-hospital mortality in emergently hospitalized dialysis-independent CKD patients irrespective of presence of inflammation.