title: The association between body mass index and mortality among Asian peritoneal dialysis patients: A meta-analysis.
abstract: BACKGROUND
  Previous studies have revealed that increased body mass index (BMI) is associated with decreased mortality among hemodialysis patients. However, few studies have dealt with the association between BMI and mortality among patients undergoing peritoneal dialysis (PD) and even fewer studies have focused on the Asian PD patients. The reported studies were often non-conclusive and some even yielded contradictory results. This paper, to our best knowledge, registers the first attempt to systematically review the current literature and summarize new results on the association between BMI and mortality among the Asian PD population.
  
  
  METHODS
  A systematic literature review was performed in Medline and EMBASE to identify relevant cohort studies on all-cause and cardiovascular disease (CVD) mortality stratified by BMI categories tailored to Asians among the Asian PD population. We meta-analyzed individual results based on a random effect model, strictly complying with Preferred Reporting Items for Systematic Reviews and Meta-analysis.
  
  
  RESULTS
  The paper reviews seven cohort studies with a total of 3,610 Asian PD patients. Obese group (BMI = 25-29.9 kg/m2) was associated with higher risk of all-cause mortality (HR = 1.46, 95%CI [1.07-1.98]; p = 0.02) and CVD mortality (HR = 2.01, 95%CI [1.14-3.54]; p = 0.02), compared to the normal group (BMI = 18.5-22.9 kg/m2). The underweight group (BMI<18.5kg/m2) was also associated with an elevated risk of all-cause mortality (HR = 2.11, 95%CI [1.46-3.07]; p<0.001). No significant associations between BMI with all-cause mortality were found among the overweight group (23-24.9 kg/m2) (HR = 1.00, 95%CI [0.76-1.32]; p = 0.9). The association between BMI and CVD mortality risk among the underweight and overweight groups was found nonsignificant (p = 0.5 and 0.6 respectively).
  
  
  CONCLUSIONS
  Obesity is associated with increased mortality in Asian PD patients. The study indicates a "V-shaped" trend in the association between BMI and mortality in these patients.
authors.affiliation: Division of Nephrology, Kidney Research Institution, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Division of Nephrology, Kidney Research Institution, West China Hospital of Sichuan University, Chengdu, Sichuan, China.|West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiaoxi
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, United States of America.
authors.forename: Hyokyoung G
authors.initials: HG
authors.lastname: Hong
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Nephrology, Kidney Research Institution, West China Hospital of Sichuan University, Chengdu, Sichuan, China.|West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Fu
mesh_terms: D015992:Body Mass Index; D006801:Humans; D009765:Obesity / Q000503:physiopathology*; D010530:Peritoneal Dialysis / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate