title: Body fat mass and lean mass as predictors of survival in hemodialysis patients.
abstract: A higher body mass index (BMI) is a predictor of better survival in hemodialysis patients, although the relative importance of body fat and lean mass has not been examined in the dialysis population. We performed an observational cohort study in 808 patients with end-stage renal disease on maintenance hemodialysis. At baseline, fat mass was measured by dual-energy X-ray absorptiometry and expressed as fat mass index (FMI; kg/m2). Lean mass index (LMI) was defined as BMI minus FMI. During the mean follow-up period of 53 months, 147 deaths, including 62 cardiovascular (CV) and 85 non-CV fatal events, were recorded. In univariate analysis, LMI was not significantly associated with CV or non-CV death, whereas a higher FMI was predictive of lower risk for non-CV death. Analyses with multivariate Cox models, which took other confounding variables as covariates, indicated the independent associations between a higher LMI and a lower risk of CV death, as well as between a higher FMI and a lower risk of non-CV death. These results indicate that increased fat mass and lean mass were both conditions associated with better outcomes in the dialysis population.
authors.affiliation: Division of Internal Medicine, Inoue Hospital, Suita, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kakiya
authors.forename: T
authors.initials: T
authors.lastname: Shoji
authors.forename: Y
authors.initials: Y
authors.lastname: Tsujimoto
authors.forename: N
authors.initials: N
authors.lastname: Tatsumi
authors.forename: S
authors.initials: S
authors.lastname: Hatsuda
authors.forename: K
authors.initials: K
authors.lastname: Shinohara
authors.forename: E
authors.initials: E
authors.lastname: Kimoto
authors.forename: H
authors.initials: H
authors.lastname: Tahara
authors.forename: H
authors.initials: H
authors.lastname: Koyama
authors.forename: M
authors.initials: M
authors.lastname: Emoto
authors.forename: E
authors.initials: E
authors.lastname: Ishimura
authors.forename: T
authors.initials: T
authors.lastname: Miki
authors.forename: T
authors.initials: T
authors.lastname: Tabata
authors.forename: Y
authors.initials: Y
authors.lastname: Nishizawa
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D001823:Body Composition; D050218:Body Fat Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011502:Protein-Energy Malnutrition / Q000000981:diagnostic imaging / Q000401:mortality*; D006435:Renal Dialysis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors