title: Body Composition and Mortality Predictors in Hemodialysis Patients.
abstract: OBJECTIVE
  To evaluate how different compartments of body composition can affect survival in hemodialysis (HD) patients.
  
  
  METHODS
  Multicenter longitudinal observational study of a cohort of patients in HD with 12 months of follow-up.
  
  
  METHODS
  Patients from 34 Nephrocare dialysis units in Portugal were included.
  
  
  METHODS
  A total of 697 patients on maintenance HD during 4 hours 3 days per week were enrolled.
  
  
  METHODS
  Dry weight, presence of diabetes, body mass index (BMI), lean tissue index (LTI), fat tissue index (FTI), body cell mass index (BCMI), albumin and hydration status were recorded at baseline. In all patients, the assessment of body composition was carried out using the Body Composition Monitor (BCM; Fresenius Medical Care a Deutschland GmbH, Germany).
  
  
  METHODS
  Survival during a 12-month period of follow-up.
  
  
  RESULTS
  Patient's mean (±standard deviation) age was 65.4 ± 14.3 years, and median (interquartile range) HD vintage was 41 (19-81) months. Patients who died during the study period, had higher age (P < .001), lower dry weight (P = .001), BMI (P < .001), albumin (P < .001), LTI (P = .015), and also lower BCMI (P = .046). Patients with diabetes (P = .045), BMI < 18.5 kg/m(2) (P < .001), albumin < 4.0 g/dL (P < .001), relative overhydration ≥ 15% (P = .001), low FTI (P = .019), and also those in the lowest tertile of BCMI (P = .022) displayed a significantly worse survival. In the Cox regression analysis, the overall mortality of patient was related to low FTI, relative overhydration, BMI < 18.5 kg/m(2), BCMI ≤ 5.2 kg/m(2), and albumin < 4.0 g/dL.
  
  
  CONCLUSIONS
  Several body composition parameters demonstrated to have an important role in predicting 1-year mortality in HD patients. Albumin, FTI, and BMI were useful predictors of mortality in these patients.
authors.affiliation: Nutrition Department, Nephrocare, Lisbon, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Caetano
authors.affiliation: Nutrition Department, Nephrocare, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Valente
authors.affiliation: Nutrition Department, Nephrocare, Lisbon, Portugal.
authors.forename: Telma
authors.initials: T
authors.lastname: Oliveira
authors.affiliation: Nutrition Department, Nephrocare, Lisbon, Portugal. Electronic address: cgaragarza@hotmail.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Garagarza
mesh_terms: D000273:Adipose Tissue; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D011174:Portugal; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality*; D014883:Water-Electrolyte Imbalance