Impact of body mass index on short-term and long-term survival in prevalent hemodialysis patients

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dc.authorid0000-0003-3491-0099en_US
dc.authorid0000-0002-9546-4507en_US
dc.authorid0000-0003-2466-2618
dc.authorid0000-0003-4399-3746
dc.authorid0000-0003-2635-6737
dc.contributor.authorErtilav, Muhittin
dc.contributor.authorLevin, W. Nathan
dc.contributor.authorÇeltik, Aygül
dc.contributor.authorKırcelli, Fatih
dc.contributor.authorStuard, Stefano
dc.contributor.authorYüksel, Kıvanç
dc.date.accessioned2021-06-23T19:51:24Z
dc.date.available2021-06-23T19:51:24Z
dc.date.issued2019
dc.departmentBAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractIntroduction: Numerous studies showed that higher body mass index (BMI) is associated with better survival in hemodialysis (HD) patients. Most of them evaluated short-term mortality. It has been suggested that presence of inflammation may be a key modifier of relationship between BMI and mortality in incident HD patients. We examined whether presence of inflammation modifies the association between BMI and mortality in both short-term and long-term follow-up in a large group of prevalent HD patients. Methods: A total of 3.252 HD patients from 41 HD centers were enrolled; the patients were divided into quartiles based on time-averaged BMI (Q1 < 21.5, Q2 21.5 to <24.3, Q3 24.3 to <27.4, Q4 >= 27.4 kg/m(2)). Inflammation status was defined as present (inflamed) (C-reactive protein (CRP) >= 1.0 mg/dL and/or serum albumin <= 3.5 g/dL) or absent (noninflamed). Findings: During 7 years of follow-up 1386 patients (42.6%) died. Compared to noninflamed patients, inflamed patients in the lowest BMI quartile showed 5-fold increased risk for mortality in the short-term (95% confidence interval [CI] 2.82-9.22, P < 0.001) and 3-fold in the long-term (95%CI 2.42-4.27, P < 0.001) compared to the highest BMI quartile. Whereas, inflamed patients in the highest BMI quartile experienced 2-fold increased risk in short-term (95%CI 1.17-3.74, P = 0.01) and 1.68-fold increased risk in long-term (95%CI 1.30-2.18, P < 0.001) than in noninflamed patients. The protective effect of BMI for overall mortality was present in all age groups, in both genders, in patient with and without diabetes. BMI was not a mortality predictor in patients with HD duration more than 76 months at baseline. The protective effect of BMI was observed in all albumin tertiles. In patients in the lowest CRP tertile, BMI was not associated with mortality. Discussion: Higher BMI is associated with lower short-term and long-term mortality risk, especially in patients with inflammation in a prevalent HD population.en_US
dc.identifier.doi10.1111/hdi.12746
dc.identifier.endpage383en_US
dc.identifier.issn1492-7535
dc.identifier.issn1542-4758
dc.identifier.issue3en_US
dc.identifier.pmid30860664en_US
dc.identifier.scopus2-s2.0-85063003176en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage375en_US
dc.identifier.urihttps://doi.org/10.1111/hdi.12746
dc.identifier.urihttps://hdl.handle.net/20.500.12491/9979
dc.identifier.volume23en_US
dc.identifier.wosWOS:000475503700022en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorErtilav, Muhittin
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofHemodialysis Internationalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBody Mass Indexen_US
dc.subjectSurvivalen_US
dc.subjectHemodialysisen_US
dc.titleImpact of body mass index on short-term and long-term survival in prevalent hemodialysis patientsen_US
dc.typeArticleen_US

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