Serum creatinine improves body mass index survival prediction in hemodialysis patients: a 1-year prospective cohort analysis from the ARNOS study.
OBJECTIVE
This study sought to better characterize the relationships between body mass index (BMI) and lean body mass (LBM) as assessed by serum creatinine (SCr) and mortality.


METHODS
The data were collected from a prospective prevalent cohort in maintenance hemodialysis patients.


METHODS
The study was carried out in 25 dialysis units in Rhônes Alpes area (France and Switzerland).


METHODS
A total of 1,205 patients were followed up for 1-year, starting July 1, 2005.


RESULTS
Mortality as well as clinical and biological routine parameters were recorded. Kaplan-Meier, Cox model, Log rank test were used for the statistical analysis.


RESULTS
We found that SCr was a strong predictor of mortality (P < .001), whereas BMI was not. Additionally, higher BMI lost its protective effect when it was associated with low SCr. Survival was strongly reduced in patients having a predialysis SCr <717 μmol/L in patients with a BMI >23 (P < .001).


CONCLUSIONS
BMI should not be used by itself but in conjunction with SCr as a surrogate of LBM to improve its morbid-mortality predictive power. LBM should also be taken into account in further survival studies carried out in hemodialysis patients.
Département de Hémodialyse, Agduc Porte de Provence, Montélimar, France. xmg@agduc.com
Xavier
X
Moreau-Gaudry
Fitsum
F
Guebre-Egziabher
Guillaume
G
Jean
Leslie
L
Genet
Dominique
D
Lataillade
Eric
E
Legrand
Francois
F
Kuentz
Pierre
P
Trolliet
Denis
D
Fouque
D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood*; D003625:Data Collection; D005260:Female; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D012709:Serum Albumin / Q000032:analysis; D013557:Switzerland
D012709:Serum Albumin; D003404:Creatinine