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Abstract: FR-PO815

Weight loss Increases Risk of Cardiovascular Events and Mortality in Incident Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kato, Sawako, Nagoya University Graduate School of Medicine, Aichi, NAGOYA, Japan
  • Lindholm, Bengt, Karolinska Institutet, Stockholm, Sweden
  • Yuzawa, Yukio, Fujita Health University School of Medicine, Toyoake, AICHI-KEN, Japan
  • Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Aichi, NAGOYA, Japan
Background

Protein-energy wasting is a common and established risk of cardiovascular events and mortality in dialysis patients, while obesity is associated with a greater survival as well known “reverse epidemiology”. Recent study suggested that short-term weight loss was more associated with worse outcome. Here we explored if weight loss just before initiation of dialysis could predict CVD events and mortality among incident dialysis patients.

Methods

In an ongoing prospective cohort study, 175 incident Japanese dialysis patients (113 males, age 59 ±11 years) were enrolled and followed for a median of 55.2 months (range 1-112 months). Laboratory biomarkers were determined at baseline. We defined [dry weight of the first month of start dialysis therapy] – [body weight at 6 months before start dialysis therapy] as the delta body weight (DBW), patients with over 5kg weight loss during this term as weight loss and patients with under 5kg weight loss or weight gain as stable weight, respectively.

Results

In Spearman rank test, DBW negatively correlated with body weight (rho=-0.15, P=0.042), abdominal circumference (rho=-0.21, P=0.007), serum CRP (rho=-0.17, P=0.032) and cardiothoracic ratio (rho=-0.20, P=0.013), while there was no correlation between DBW and body mass index (BMI). In Kaplan-Meier curves, the CVD death was associated with weight loss (Log rank 5.91, P = 0.015). And the duration from start of dialysis therapy to the first CVD events was significantly shorter in patients with weight loss (Log rank 10.74, P = 0.001). In Cox hazard model, after adjustments for age, gender, and BMI, the weight loss had a significantly increased relative risk of CVD deaths (2.89, 95% CI; 1.05-9.22, P = 0.0385).

Conclusion

In Japanese incident dialysis patients, short-term weight loss just before initiation dialysis therapy associated with increased risk of CVD deaths and events. These results may suggest that we should pay attention to lean losing weight rather than physical status.