Hypertension and nephrology

[Association of body composition and mortality in patients on maintenance dialysis]

UJSZÁSZI Ákos1, KALANTAR-ZADEH Kamyar2,3, MOLNÁR Miklós Zsolt1,2,4

SEPTEMBER 20, 2011

Hypertension and nephrology - 2011;15(04)

[Overweight [body mass index (BMI) = 25-30 kg/m2] and obesity (BMI ≥30 kg/m2) have become mass phenomena with a pronounced upward trend in prevalence in most countries throughout the world and are associated with increased cardiovascular risk and poor survival. In patients with end stage renal disease (ESRD) undergoing maintenance hemodialysis an “obesity paradox” has been consistently reported, i.e., a higher BMI is incrementally associated with better survival. Whereas this “reverse epidemiology” of obesity is relatively consistent in maintenance hemodialysis patients, studies in peritoneal dialysis patients have yielded mixed results. However, BMI is unable to differentiate between adiposity and muscle mass and may not be an acceptable metric to assess the body composition of ESRD patients. Assessing lean body mass, in particular skeletal muscle, and fat mass separately are needed in ESRD patients using gold standard techniques such as imaging techniques. Alternatively, inexpensive and routinely measured surrogate markers such as serum creatinine, waist and hip circumference or mid-arm muscle circumference can be used. We have reviewed and summarized salient recent data pertaining to body composition and clinical outcomes about the association of survival and body composition in peritoneal and hemodialysis patients.]

AFFILIATIONS

  1. Semmelweis Egyetem, Kórélettani Intézet, Budapest
  2. Harold Simmons Center for Chronic Disease Research & Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, Egyesült Államok
  3. David Geffen School of Medicine at UCLA, Los Angeles, CA, Egyesült Államok
  4. Semmelweis Egyetem, Magatartástudományi Intézet, Budapest

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