Abstract: SA-PO774

Heights of Hemodialysis Patients Are Associated with Outcomes: Results From the Monitoring Dialysis Outcomes (Mondo) Initiative

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Patel, Samir D., Renal Research Institute, New York, New York, United States
  • Kooman, Jeroen, Maastricht University Medical Centre , Maastricht, Netherlands
  • van der Sande, Frank, Maastricht University Medical Centre , Maastricht, Netherlands
  • Usvyat, Len A., Fresenius Medical Care North America, Melrose, Massachusetts, United States
  • Wang, Yuedong, University of California - Santa Barbara, Santa Barbara, California, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Carioni, Paola, Fresenius Medical Care Italia, Palazzo Pignano, Italy
  • Topping, Alice, Renal Research Institute, New York, New York, United States
  • Ye, Xiaoling, Renal Research Institute, New York, New York, United States
  • Canaud, Bernard J., FMC Deutschland GmbH, Bad Homburg, Germany
  • Marelli, Cristina, Fresenius Medical Care Argentina, buenos Aires, Argentina
  • Guinsburg, Adrian M., Fresenius Medical Care, Moron, Argentina
  • Xu, Xiaoqi, Fresenius Medical Care Asia Pacific, Hong Kong, China
  • Power, Albert J., Richard Bright Renal Unit, Bristol, United Kingdom
  • Duncan, Neill D., Imperial College Renal and Transplant Centre, London, LONDON, United Kingdom
Background

In the general population taller people have better metabolic profiles and cardiovascular outcomes (Nelson NEJM 2015), a finding reversed in hemodialysis (HD) patients (pts) (Shapiro CJASN 2015, Elsayed JASN 2015). We studied this relationship in incident HD pts in the international MONDO database.

Methods

In this retrospective cohort study, we included incident HD pts commencing treatment between 01/01/2006 and 12/31/2010, and noted their outcome over 2.5 years following a 6 months baseline. Patients were stratified into deciles of their respective database population, [Asia-Pacific (AP), North (NA) and South America (SA), Europe (EU)], and by gender. Analysis was done using Cox regression with height decile 5 as reference. We constructed 3 different models: a simple case-mix adjusted model for age, gender, post-dialysis weight (Figure 1); the second model additionally including eKt/V (Figure 2); and a fully adjusted model further including albumin, interdialytic weight gain, phosphorus, and pre dialysis systolic blood pressure (Figure 3).

Results

We studied 23,353 pts (62 ± 15 years old, 42% females, body mass index 26 ±6 kg/m2, 165 ± 10 cm tall). In the fully adjusted models, for SA we found a trend of increasing hazard ratio (HR) without significance among deciles > 5. In EU, deciles 8-10 had significantly increased HR. We observed no significant trend in AP and NA (Figure 3). The result remains materially identical in adjusted models.

Conclusion

Taller height associates with poorer outcomes for reasons yet to be elucidated. Trends we observed were not consistent between continents. Additional studies including body composition analysis may provide additional insight.

Forrest plots of height decile and mortality. Figure 1, Figure 2, Figure 3.