Kidney Week

Abstract: SA-PO1055

Inverse Relationship Between Waist Circumference and Body Mass Index on Risk for All-Cause Mortality in Hemodialysis Patients: A Nationwide Population-Based Cohort Study

Session Information

• Hemodialysis and Frequent Dialysis - VI
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Kim, Chang Seong, Chonnam National University Medical School , Gwangju, Korea (the Republic of)

Chang Seong Kim,

• Choi, Hong sang, Chonnam National University Hospital, Gwangju, Korea (the Republic of)

Hong sang Choi,

• Bae, Eun Hui, Chonnam National University Hospital, Gwangju, Korea (the Republic of)

Eun Hui Bae,

• Ma, Seong Kwon, Chonnam National University Medical School , Gwangju, Korea (the Republic of)

Seong Kwon Ma,

• Kim, Soo Wan, Chonnam National University Medical School , Gwangju, Korea (the Republic of)

Soo Wan Kim,

Background

Obesity underlies a high risk of all-cause and cardiovascular mortality in patients with end-stage renal disease. We investigated that the association between waist circumference and body mass index (BMI) and mortality in patients undergoing hemodialysis through a nationwide large population-based study.

Methods

Using nationally representative data from the Korean National Health Insurance System, 6,823,298 participants aged over 40 years with information for waist circumference and BMI were followed up during 4.5 years.

Results

The mortality rate is greater in hemodialysis patients with highest waist circumference category than those with lowest waist circumference category (5.67 per 100 person-years, ≥ 100 cm in men and ≥ 95 cm in women; 4.09 per 100 person-years, < 80 in men and < 75 in women). However, participants with higher BMI showed lower mortality rate than those with lower BMI (3.83 per 100 person-years in ≥ 30 kg/m² and 6.87 in < 18.5 kg/m²). Multivariable Cox regression analysis found that participants with highest waist circumference category had higher risk of all-cause mortality than those with waist circumference 85 to 90 in men and 80 to 85 in women (reference group) [adjusted hazard ratio (HR), 1.280; 95% confidence interval (CI), 1.057−1.550], while those with lowest waist circumference category showed significantly lower risk of mortality compared to reference group (adjusted HR, 0.819; 95% CI, 1.410−1.929). Inversely, BMI categories ≥ 23 kg/m² were associated with significantly lower risk for mortality compared to the reference group (18.5 to 23 kg/m²), with adjusted HR of 0.734 for BMI of 23 to 25 kg/m², 0.591 for BMI of 25 to 30 kg/m² and 0.530 for BMI ≥ 30 kg/m².

Conclusion

Central obesity measured by waist circumference is associated with all-cause mortality in hemodialysis patients, whereas body volume measured by BMI is an inverse relationship with this outcome.