title: Obesity and atherosclerotic events in chronic hemodialysis patients: a prospective study.
abstract: BACKGROUND
  Studies exploring the impact of overweight on mortality have reported controversial results in dialysis patients; some have found overweight to increase mortality, whereas others suggest that it offers a survival advantage. We conducted a prospective study to evaluate the impact of overweight on atherosclerotic events (AE) in dialysis patients with special respect to the malnutrition/inflammation complex syndrome (MICS).
  
  
  METHODS
  Five hundred and forty-one hemodialysis patients from 11 dialysis centers in France were included. A number of baseline parameters including traditional and non-traditional cardiovascular (CV) risk factors were measured and the cohort was followed prospectively.
  
  
  RESULTS
  Over a mean follow-up of 39 months, 207 patients (38.3%) experienced an AE. Overweight, defined by a body mass index greater than 25 kg/m(2), was associated with increased risk of AEs [RR: 1.68 (CI: 1.11-3.56)], and CV mortality [RR: 1.51 (CI: 1.07-2.13)]. The effect of overweight was different in patients with and without MICS. Age, diabetes, a previous history of CV disease, high serum levels of homocysteine and MICS were also associated with an increased risk of AEs.
  
  
  CONCLUSIONS
  Similar to the general population, overweight contributes to an increased risk for AEs and CV mortality in hemodialysis patients. The presence or absence of MICS can modify the impact of overweight on development of AEs and mortality in this population.
authors.affiliation: Department of Nephrology, Dialysis, and Renal Transplantation, University of Franche-Comté, Besançon, France.
authors.forename: Amir
authors.initials: A
authors.lastname: Kazory
authors.forename: Alexandre
authors.initials: A
authors.lastname: Klein
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chalopin
authors.forename: Didier
authors.initials: D
authors.lastname: Ducloux
authors.forename: Cécile
authors.initials: C
authors.lastname: Courivaud
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000209:etiology*; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D005602:France; D006801:Humans; D007249:Inflammation / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors
keywords: hemodialysis; inflammation; kidney disease; malnutrition; obesity