Elevated BMI Cuts Dialysis Death Risk
Overweight patients on hemodialysis have a survival advantage, a new study confirms.
“We know a high BMI in the general population is associated with an increased risk of cardiovascular disease and all-cause mortality, but in maintenance hemodialysis patients, baseline obesity paradoxically appears to be associated with improved survival,” lead investigator Charles Chazot, MD, of NephroCare in
Investigators analyzed data from approximately 6,000 end-stage renal failure patients treated in 85 dialysis centers in
Despite higher comorbidity rates in the overweight and obese groups, their risk of death was about 30% lower than that of underweight and normal-weight patients, and this survival advantage persisted after accounting for age, diabetes and other comorbidities.
The “reverse” relationship between BMI and survival in hemodialysis patients was first reported by French investigatorsin 1982, Dr. Chazot noted. Twenty-five years later—and in a population that is now significantly older with many more comorbidities than earlier dialysis populations—“this relationship is still present,” he said, “and this confirms the reverse epidemiology [concept] previously reported in