International Urology and Nephrology

, Volume 46, Issue 3, pp 623–631

Body mass index and mortality in patients on maintenance hemodialysis: a meta-analysis

Authors

  • Ting Li
    • Department of Nephrology, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong University
  • Jun Liu
    • Department of Nephrology, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong University
  • Shuxian An
    • Department of Nephrology, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong University
  • Yan Dai
    • Department of Nephrology, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong University
    • Department of Nephrology, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong University
Nephrology - Original Paper

DOI: 10.1007/s11255-014-0653-x

Cite this article as:
Li, T., Liu, J., An, S. et al. Int Urol Nephrol (2014) 46: 623. doi:10.1007/s11255-014-0653-x

Abstract

Purpose

In patients undergoing maintenance hemodialysis (MHD), increasing numbers of studies have reported a reduced mortality in patients with an increased body mass index (BMI). This article provides a meta-analysis on the assessment of the relationship between BMI and mortality in MHD patients.

Methods

A systemic literature review was conducted to identify studies that examined all-cause mortality, with or without cardiovascular events, on the basis of bodyweight or obesity measures in MHD population published before October 2012.

Results

Eight observational studies with a total of 190,163 patients were included. Compared to the individuals with a normal BMI, overweight patients and obese patients were associated with lower all-cause mortality [relative risk (RR) 0.86, 95 % confidence interval (CI) 0.84–0.88; RR 0.77, 95 % CI 0.75–0.78, respectively] and cardiovascular mortality (RR 0.86; 95 % CI 0.81–0.91; RR 0.78, 95 % CI 0.73–0.83, respectively). Underweight patients had relatively higher all-cause and cardiovascular mortality (RR 1.22, 95 % CI 1.20–1.25; RR 1.19, 95 % CI 1.11–1.28, respectively). In an obesity-stratified analysis, the patients with moderate or severe obesity presented a strongly decreased all-cause mortality risk (RR 0.64, 95 % CI 0.61–0.68) and cardiovascular mortality risk (RR 0.63, 95 % CI 0.53–0.75) compared to patients with mild obesity (RR 0.74, 95 % CI 0.71–0.77; RR 0.81, 95 % CI 0.75–0.87, respectively).

Conclusions

These findings show that overweight and obese patients have lower all-cause and cardiovascular mortality rates in patients undergoing MHD. Body weight management and optimized nutritional and metabolic support should help to reduce the high mortality rates that are prevalent in the hemodialysis population.

Keywords

Body mass index (BMI)HemodialysisMortalityMeta-analysis

Copyright information

© Springer Science+Business Media Dordrecht 2014