Abstract: SA-PO1040
The Association of Dialysis Adequacy, Body Mass Index, and Mortality Among Hemodialysis Patients
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
- Yang, Kyung Hoon, Samsung Changwon Hospital, Changwon, Korea (the Republic of)
- Lim, Yuntac, samsungchangwon hospital, Busan, Korea (the Republic of)
- Lee, Yuji, University of California at Irvine, Orange, California, United States
Background
We examined the relationship between adequacy of hemodialysis (HD) and mortality in HD patients according to body mass index (BMI).
Methods
We retrospectively reviewed patient data from the Korean Society of Nephrology registry, a nationwide database of medical records of HD patients, from January 2001 to June 2017. We included patients who were ≥18 years old and receiving maintenance HD. Patients were categorized into three groups according to baseline BMI (<20 (low), 20 to <23 (normal), and ≥23 (high) kg/m2). Baseline spKt/V was divided into six categories.
Results
Among 18,242 patients on HD, the median follow-up duration was 5.2 (IQR, 1.9–8.9) years. Cox regression analysis showed that, compared to the reference (spKt/V 1.2–1.4), lower and higher baseline spKt/V were associated with greater and lower risks for all-cause mortality, respectively. However, among patients with high BMI (n=5,588), the association between higher spKt/V and lower all-cause mortality was attenuated in all adjusted models (Pinteraction<0.001). Compared to patients with normal BMI and spKt/V within the target range (1.2–1.4), those with low BMI had a higher risk for all-cause mortality at all spKt/V range. However, the gap in mortality risk became narrower for higher values of spKt/V. Compared to patients with normal BMI and spKt/V in the target range, those with high BMI and spKt/V <1.2 were not at increased risk for mortality despite low dialysis adequacy.
Conclusion
The association between spKt/V and mortality in HD patients may be modified by BMI.