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

  • Nephrology - Original Paper
  • Published:
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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.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Nephrology, Shanghai First People’s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 100 Haining Road, Shanghai, 200080, People’s Republic of China

    Ting Li, Jun Liu, Shuxian An, Yan Dai & Qing Yu

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  1. Ting Li
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  2. Jun Liu
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  3. Shuxian An
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  4. Yan Dai
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  5. Qing Yu
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Correspondence to Qing Yu.

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Ting Li and Jun Liu have contributed equally to this work.

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Li, T., Liu, J., An, S. et al. Body mass index and mortality in patients on maintenance hemodialysis: a meta-analysis. Int Urol Nephrol 46, 623–631 (2014). https://doi.org/10.1007/s11255-014-0653-x

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