Serum Creatinine Modifies Associations between Body Mass Index and Mortality and Morbidity in Prevalent Hemodialysis Patients

• DOI: 10.1371/journal.pone.0150003
• Publication Date: 2016-03-01T19:06:02Z
• Authors: Yukitoshi Sakao; Toshiyuki Ojima; Hideo Yasuda; Seiji Hashimoto; Takeshi Hasegawa; Kunitoshi Iseki; Yoshiharu Tsubaki...; Akihiko Kato
• Keywords: Male; 2. Zero hunger; Hip Fractures; Science; Q; R; Middle Aged; Body Mass Index; 3. Good health; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Cardiovascular Diseases; Renal Dialysis; Creatinine; Prevalence; Medicine; Humans; Kidney Failure, Chronic; Female; Biomarkers; Research Article; Aged

High body mass index (BMI) is paradoxically associated with better outcomes in hemodialysis (HD) patients. This study aimed to examine whether serum creatinine (Cr), a marker of muscle mass, could modify the association between BMI, and mortality morbidity prevalent HD patients.A retrospective was conducted using nationwide database from registry Japanese Society for Dialysis Therapy. A total 119,099 patients were selected (age: 65±12 years; median time on HD: 5.6 male: 62%), we examined basal BMI after 1-year period. Patients stratified either by into 4 groups or Cr levels 3 tertiles. Odds ratio (OR) [95% confidence interval] calculated multivariate logistic regression analysis.Higher did not predict higher mortality. However, when levels, risk cardiac death became significantly obese lowest both males (OR 2.82 [1.51-5.27], p<0.01) females 2.00 [1.03-3.90], p<0.05). The new cerebral infarction also male within tertile. In contrast, there lower cardiac, cerebrovascular, infection-related non-obese Cr. Higher related cardiovascular events hip fracture patients.The obesity paradox found be present only defined BMI. Decreased positively clinical poor all groups. Thus, irrespective evaluation important receiving regular HD.