title: Association of Height with Mortality in Patients Undergoing Maintenance Hemodialysis.
abstract: OBJECTIVE
  Body mass index (BMI), determined as kilograms in body weight divided by the square of the height in meters (m(2)), is inversely associated with mortality in patients undergoing maintenance hemodialysis (MHD). It is commonly inferred that differences in the weight component of the BMI equation are responsible for this negative correlation. However, there are almost no data on the relationship between height and mortality in these patients. This study was conducted to examine the association between height and mortality in MHD patients and to evaluate the contribution of height to the BMI-mortality relationship.
  
  
  METHODS
  A prospective study conducted from July 1, 2001, through June 30, 2006, enrolled a nationally representative cohort of 117,644 MHD patients receiving treatment in DaVita, Inc. outpatient dialysis facilities with (1) known height and weight, (2) age ≥18 years, (3) dialysis vintage ≥90 days, and (4) nonoutlying BMI values (≥12 to ≤60 kg/m(2)). The end date of follow-up was June 30, 2007, and median follow-up was 852 days (interquartile range, 504-1367 days). Mortality hazard ratios were computed within sex-standardized deciles of height and weight, and outcomes included all-cause mortality and cardiovascular, gastrointestinal, cancer, and infection mortality. Hazard models were unadjusted, adjusted for case-mix variables, or adjusted for case-mix variables plus laboratory variables.
  
  
  RESULTS
  Mean age was 61±15 years; 45% of patients were women and 57% had diabetes. In adjusted models, height, also adjusted for weight, was directly associated with all-cause mortality and cardiovascular, infection, and cancer mortality. Compared with the median height decile, mortality risk in the highest height decile was 1.18 (95% confidence interval, 1.14 to 1.23) in fully adjusted analyses (P<0.001). Receiver-operating characteristic curves indicated that in adjusted analyses the contribution of height to the relationship between BMI and mortality was almost identical to that of weight.
  
  
  CONCLUSIONS
  In MHD patients, height is positively associated with mortality risk and contributes similarly to weight with regard to the negative BMI-mortality relationship.
authors.affiliation: Harold Simmons Center for Kidney Disease Research and Epidemiology and Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California;
authors.forename: Bryan B
authors.initials: BB
authors.lastname: Shapiro
authors.affiliation: Harold Simmons Center for Kidney Disease Research and Epidemiology and.
authors.forename: Elani
authors.initials: E
authors.lastname: Streja
authors.affiliation: Harold Simmons Center for Kidney Disease Research and Epidemiology and.
authors.forename: Vanessa A
authors.initials: VA
authors.lastname: Ravel
authors.affiliation: Harold Simmons Center for Kidney Disease Research and Epidemiology and UCLA Fielding School of Public Health, Los Angeles, California; Division of Nephrology and Hypertension, University of California at Irvine, Orange, California; and.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.affiliation: Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; UCLA Fielding School of Public Health, Los Angeles, California; David Geffen School of Medicine at UCLA, Los Angeles, California jkopple@labiomed.org.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kopple
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001827:Body Height; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: body mass index; chronic renal disease; clinical epidemiology
references.citation: J Am Coll Cardiol. 1996 Mar 1;27(3):678-82
references.pmid: 8606281
references.citation: Clin J Am Soc Nephrol. 2009 Oct;4(10):1551-8
references.pmid: 19696217
references.citation: J Clin Pathol. 1966 Jul;19(4):389-91
references.pmid: 5929341
references.citation: Am J Phys Anthropol. 1990 Dec;83(4):467-76
references.pmid: 2275484
references.citation: Cancer Epidemiol Biomarkers Prev. 2013 Aug;22(8):1353-63
references.pmid: 23887996
references.citation: Am J Clin Nutr. 2005 Mar;81(3):543-54
references.pmid: 15755821
references.citation: Anatol J Cardiol. 2015 Apr;15(4):313-7
references.pmid: 25413228
references.citation: Public Health. 1992 Sep;106(5):375-82
references.pmid: 1410222
references.citation: Nephrol Dial Transplant. 2001 Dec;16(12):2386-94
references.pmid: 11733631
references.citation: JACC Cardiovasc Imaging. 2011 Jul;4(7):754-61
references.pmid: 21757166
references.citation: Lancet. 1999 Jul 10;354(9173):93-9
references.pmid: 10408483
references.citation: Nephrol Dial Transplant. 2000;15 Suppl 1:25-8
references.pmid: 10737163
references.citation: Nephrol Dial Transplant. 2000;15 Suppl 2:7-11
references.pmid: 11051031
references.citation: Nephrol Dial Transplant. 1999 Jan;14(1):147-53
references.pmid: 10052495
references.citation: Am J Physiol. 1976 Nov;231(5 Pt. 1):1568-72
references.pmid: 998803
references.citation: J Epidemiol Community Health. 1989 Dec;43(4):380-4
references.pmid: 2614330
references.citation: Hypertension. 2010 Aug;56(2):217-24
references.pmid: 20566959
references.citation: Hum Biol. 1989 Jun;61(3):415-25
references.pmid: 2807265
references.citation: Am J Kidney Dis. 2000 Jan;35(1):80-8
references.pmid: 10620548
references.citation: J Clin Hypertens (Greenwich). 2013 Mar;15(3):176-9
references.pmid: 23458589
references.citation: QJM. 1999 Oct;92(10):595-600
references.pmid: 10627881
references.citation: Kidney Int. 1996 Aug;50(2):550-6
references.pmid: 8840285
references.citation: Am J Epidemiol. 2008 Sep 1;168(5):497-505
references.pmid: 18660491
references.citation: J Am Coll Cardiol. 2010 Mar 30;55(13):1318-27
references.pmid: 20338492
references.citation: J Epidemiol Community Health. 2000 Feb;54(2):97-103
references.pmid: 10715741
references.citation: Cancer Res. 1988 Mar 15;48(6):1658-62
references.pmid: 3345534
references.citation: Cardiol Res Pract. 2010 Nov 11;2011:242353
references.pmid: 21113297
references.citation: Kidney Int. 2003 May;63(5):1852-60
references.pmid: 12675863
references.citation: Int J Epidemiol. 2011 Dec;40(6):1715-26
references.pmid: 22268239
references.citation: J Am Soc Nephrol. 2002 Apr;13(4):1061-6
references.pmid: 11912267
references.citation: Int J Epidemiol. 2012 Oct;41(5):1419-33
references.pmid: 22825588
references.citation: Lancet Oncol. 2011 Aug;12(8):785-94
references.pmid: 21782509
references.citation: Stroke. 2007 Jan;38(1):22-6
references.pmid: 17138947
references.citation: Curr Opin Nephrol Hypertens. 2011 Nov;20(6):662-8
references.pmid: 21825982
references.citation: Am J Epidemiol. 2000 Jun 1;151(11):1112-20
references.pmid: 10873136
references.citation: Toxins (Basel). 2014 Mar;6(3):934-49
references.pmid: 24599232
references.citation: Am J Nephrol. 2013;38(2):136-48
references.pmid: 23941724
references.citation: Circulation. 1994 Nov;90(5):2241-7
references.pmid: 7955180
references.citation: Ann Oncol. 2010 Mar;21(3):646-54
references.pmid: 19889610
references.citation: Kidney Int. 2006 Mar;69(6):1081-7
references.pmid: 16421516
references.citation: Clin J Am Soc Nephrol. 2010 Dec;5(12):2144-5
references.pmid: 20947784
references.citation: J Epidemiol Community Health. 1995 Feb;49(1):5-9
references.pmid: 7707006