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Abstract: SA-PO1040

The Association of Dialysis Adequacy, Body Mass Index, and Mortality Among Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • 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

We examined the relationship between adequacy of hemodialysis (HD) and mortality in HD patients according to body mass index (BMI).


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.


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.


The association between spKt/V and mortality in HD patients may be modified by BMI.