Black HD Patients Benefit More from Obesity

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Obesity is associated with greater survival in African-American maintenance hemodialysis (MHD) patients compared with other races, according to a study.

Kamyar Kalantar-Zadeh, MD, MPH, PhD, Director of Dialysis Expansion & Epidemiology at the Harbor-UCLA in Torrance, and collaborators examined the association between BMI and the survival advantages in chronic disease states in a cohort study of 138,773 patients undergoing maintenance hemodialysis (MHD).

The study population included 43,848 African Americans and 94,925 non-African Americans. The two groups had a mean age of 58 and 63 years, respectively. In addition, 49% and 43% of the groups were female and 46% and 48% were diabetic.

Overall, African-American patients who were obese (defined as a BMI above 30 kg/m2) had greater survival rates than obese non-African Americans.

The investigators reported that African-Americans with high BMI (40 and above but less than 45) had a 30% decreased risk of mortality compared with subjects whose BMI was 23 or higher but less than 25 (reference group). In non-African Americans, those with a BMI above 25 did not have a significant survival advantage, except for subjects with a BMI of 40 or higher but less than 45, who had a 14% decreased risk of death.

The team concluded that the survival advantages of obesity may be a contributor to the overall greater survival observed in African-American dialysis patients.

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