Abstract
Background: Although obesity confers an increased risk of mortality in the general population, observational reports on the dialysis population have suggested that obesity is associated with improved survival. These reports have generally not examined extremely high values of body mass index (BMI; in kg/m 2), survival >1 y, or alternative measures of adiposity. Objective: We sought to clarify the relation between body size and outcomes among a large cohort of patients beginning dialysis. Design: Data on 418 055 patients beginning dialysis between 1 April 1995 and 1 November 2000 were analyzed by using US Renal Data System data. BMI was divided into 8 categories in increments of 3 units, ranging from <19 to ≥37, and the relation between survival and BMI was examined by using proportional hazards regression with adjustment for demographic, laboratory, and comorbidity data. Results: High BMI was associated with increased survival in this cohort, even at extremely high BMI, after adjustment, and over a 2-y average follow-up time. This was true for whites, African Americans, and Hispanics but not for Asians. High BMI was also associated with a reduced risk of hospitalization and a lower rate of mortality in all mortality categories. Alternative estimates of adiposity, including the Benn index and estimated fat mass, yielded similar results, and adjustments for lean body mass did not substantially alter the findings. Conclusions: High BMI is not associated with increased mortality among patients beginning dialysis. This finding does not appear to be a function of lean body mass and, although modified by certain patient characteristics, it is a robust finding.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 324-332 |
| Number of pages | 9 |
| Journal | American Journal of Clinical Nutrition |
| Volume | 80 |
| Issue number | 2 |
| State | Published - Aug 2004 |
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Keywords
- Adiposity
- Body mass index
- Dialysis
- End-stage renal disease
- Outcomes
- Survival
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Food Science
Cite this
Association of body size with outcomes among patients beginning dialysis 1-5. / Johansen, Kirsten L.; Young, Belinda; Kaysen, George; Chertow, Glenn M.
In: American Journal of Clinical Nutrition, Vol. 80, No. 2, 08.2004, p. 324-332.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association of body size with outcomes among patients beginning dialysis 1-5
AU - Johansen, Kirsten L.
AU - Young, Belinda
AU - Kaysen, George
AU - Chertow, Glenn M.
PY - 2004/8
Y1 - 2004/8
N2 - Background: Although obesity confers an increased risk of mortality in the general population, observational reports on the dialysis population have suggested that obesity is associated with improved survival. These reports have generally not examined extremely high values of body mass index (BMI; in kg/m 2), survival >1 y, or alternative measures of adiposity. Objective: We sought to clarify the relation between body size and outcomes among a large cohort of patients beginning dialysis. Design: Data on 418 055 patients beginning dialysis between 1 April 1995 and 1 November 2000 were analyzed by using US Renal Data System data. BMI was divided into 8 categories in increments of 3 units, ranging from <19 to ≥37, and the relation between survival and BMI was examined by using proportional hazards regression with adjustment for demographic, laboratory, and comorbidity data. Results: High BMI was associated with increased survival in this cohort, even at extremely high BMI, after adjustment, and over a 2-y average follow-up time. This was true for whites, African Americans, and Hispanics but not for Asians. High BMI was also associated with a reduced risk of hospitalization and a lower rate of mortality in all mortality categories. Alternative estimates of adiposity, including the Benn index and estimated fat mass, yielded similar results, and adjustments for lean body mass did not substantially alter the findings. Conclusions: High BMI is not associated with increased mortality among patients beginning dialysis. This finding does not appear to be a function of lean body mass and, although modified by certain patient characteristics, it is a robust finding.
AB - Background: Although obesity confers an increased risk of mortality in the general population, observational reports on the dialysis population have suggested that obesity is associated with improved survival. These reports have generally not examined extremely high values of body mass index (BMI; in kg/m 2), survival >1 y, or alternative measures of adiposity. Objective: We sought to clarify the relation between body size and outcomes among a large cohort of patients beginning dialysis. Design: Data on 418 055 patients beginning dialysis between 1 April 1995 and 1 November 2000 were analyzed by using US Renal Data System data. BMI was divided into 8 categories in increments of 3 units, ranging from <19 to ≥37, and the relation between survival and BMI was examined by using proportional hazards regression with adjustment for demographic, laboratory, and comorbidity data. Results: High BMI was associated with increased survival in this cohort, even at extremely high BMI, after adjustment, and over a 2-y average follow-up time. This was true for whites, African Americans, and Hispanics but not for Asians. High BMI was also associated with a reduced risk of hospitalization and a lower rate of mortality in all mortality categories. Alternative estimates of adiposity, including the Benn index and estimated fat mass, yielded similar results, and adjustments for lean body mass did not substantially alter the findings. Conclusions: High BMI is not associated with increased mortality among patients beginning dialysis. This finding does not appear to be a function of lean body mass and, although modified by certain patient characteristics, it is a robust finding.
KW - Adiposity
KW - Body mass index
KW - Dialysis
KW - End-stage renal disease
KW - Outcomes
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=4344700873&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=4344700873&partnerID=8YFLogxK
M3 - Article
C2 - 15277152
AN - SCOPUS:4344700873
VL - 80
SP - 324
EP - 332
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
SN - 0002-9165
IS - 2
ER -