Hyung-Seok Lee1,2, Sung Gyun Kim1,2, Jwa-Kyung Kim1,2, Young Ki Lee3,2, Jung Woo Noh3,2, Jieun Oh4,2, Hyung Jik Kim1,2, Young Rim Song1,2. 1. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea. 2. Kidney Research Institute, Hallym University College of Medicine, Chuncheon-si, Republic of Korea. 3. Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea. 4. Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea.
Abstract
BACKGROUND: Although higher body mass index (BMI) is associated with better survival in patients undergoing dialysis, BMI is not an adequate obesity indicator. We hypothesized that the fat-to-lean (F/L) mass ratio could be a suitable marker of nutritional status and evaluated its prognostic impact on long-term outcomes in patients undergoing hemodialysis (HD). METHODS: In total, 131 patients undergoing HD were recruited and monitored prospectively for up to 5 years. Body composition was analyzed, and other nutritional and inflammatory parameters were measured. RESULTS: The mean age of the cohort was 60.7 ± 13.6 years, and 65 patients were diabetic. Age, sex, diabetes, comorbidity, and inflammation were associated significantly with the F/L mass ratio. During the follow-up period, 21 patients experienced cardiac events and 22 patients died. Patients with higher F/L mass ratios had significantly higher risks of all-cause death (hazard ratio [HR] 3.61, 95% CI 1.07-12.13; p = 0.038) and cardiac events (HR 3.54, 95% CI 1.05-11.94; p = 0.041) than those with lower F/L mass ratios. CONCLUSIONS: The F/L mass ratio was a useful surrogate marker of nutritional and inflammatory status, and an independent predictor of cardiac events and all-cause mortality, in patients undergoing HD.
BACKGROUND: Although higher body mass index (BMI) is associated with better survival in patients undergoing dialysis, BMI is not an adequate obesity indicator. We hypothesized that the fat-to-lean (F/L) mass ratio could be a suitable marker of nutritional status and evaluated its prognostic impact on long-term outcomes in patients undergoing hemodialysis (HD). METHODS: In total, 131 patients undergoing HD were recruited and monitored prospectively for up to 5 years. Body composition was analyzed, and other nutritional and inflammatory parameters were measured. RESULTS: The mean age of the cohort was 60.7 ± 13.6 years, and 65 patients were diabetic. Age, sex, diabetes, comorbidity, and inflammation were associated significantly with the F/L mass ratio. During the follow-up period, 21 patients experienced cardiac events and 22 patients died. Patients with higher F/L mass ratios had significantly higher risks of all-cause death (hazard ratio [HR] 3.61, 95% CI 1.07-12.13; p = 0.038) and cardiac events (HR 3.54, 95% CI 1.05-11.94; p = 0.041) than those with lower F/L mass ratios. CONCLUSIONS: The F/L mass ratio was a useful surrogate marker of nutritional and inflammatory status, and an independent predictor of cardiac events and all-cause mortality, in patients undergoing HD.
Authors: Natascha J H Broers; Bernard Canaud; Marijke J E Dekker; Frank M van der Sande; Stefano Stuard; Peter Wabel; Jeroen P Kooman Journal: Hemodial Int Date: 2020-01-22 Impact factor: 1.812