Akira Onozaki1, Daiji Nagayama2,3, Nakanobu Azuma1, Keita Sugai4, Etsuko Shitara4, Takehiko Sakai5, Motoyuki Masai5, Kohji Shirai6, Ichiro Tatsuno3,7. 1. Internal Medicine, Tokatsu Clinic Hospital, Chiba, Japan. 2. Internal Medicine, Nagayama Clinic, Tochigi, Japan. 3. Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan. 4. Nutrition Management Division, Mihama Hospital, Chiba, Japan. 5. Department of Urology, Mihama Hospital, Chiba, Japan. 6. Internal Medicine, Mihama Hospital, Chiba, Japan. 7. Chiba Prefectural University of Health Sciences, Chiba, Japan.
Abstract
OBJECTIVE: The aim of this study was to investigate the association of the maximum lifetime body mass index (max BMI) with hemodialysis initiation and comorbidities in Japanese hemodialysis patients. METHODS: In a retrospective cross-sectional study on 724 hemodialysis patients, max BMI, age at hemodialysis initiation, and comorbidities including sleep apnea syndrome, cerebro-cardiovascular diseases, and proliferative diabetic retinopathy (PDR) were analyzed. Early hemodialysis initiation was defined as age <50 years. RESULT: Diabetes patients showed a higher max BMI and prevalence of atherosclerotic diseases than nondiabetes patients, despite almost the same age at hemodialysis initiation. Patients with early hemodialysis initiation showed higher male ratio, prevalence of PDR, and max BMI than those with later initiation, despite almost equal prevalence of diabetes. Receiver-operating characteristic curve analysis determined a max BMI of 28.4 kg/m2 as a reliable cutoff value for predicting early hemodialysis initiation, and this parameter was identified as an independent predictor of early hemodialysis initiation using bivariate logistic regression analysis. Vitrectomy for PDR also tended to contribute independently to early hemodialysis initiation. CONCLUSION: A high max BMI contributed to early hemodialysis initiation independent of diabetes. Furthermore, PDR was associated with a high max BMI and early hemodialysis initiation. These results suggest that weight reduction in young chronic kidney disease patients with obesity may prevent hemodialysis and blindness.
OBJECTIVE: The aim of this study was to investigate the association of the maximum lifetime body mass index (max BMI) with hemodialysis initiation and comorbidities in Japanese hemodialysis patients. METHODS: In a retrospective cross-sectional study on 724 hemodialysis patients, max BMI, age at hemodialysis initiation, and comorbidities including sleep apnea syndrome, cerebro-cardiovascular diseases, and proliferative diabetic retinopathy (PDR) were analyzed. Early hemodialysis initiation was defined as age <50 years. RESULT: Diabetes patients showed a higher max BMI and prevalence of atherosclerotic diseases than nondiabetes patients, despite almost the same age at hemodialysis initiation. Patients with early hemodialysis initiation showed higher male ratio, prevalence of PDR, and max BMI than those with later initiation, despite almost equal prevalence of diabetes. Receiver-operating characteristic curve analysis determined a max BMI of 28.4 kg/m2 as a reliable cutoff value for predicting early hemodialysis initiation, and this parameter was identified as an independent predictor of early hemodialysis initiation using bivariate logistic regression analysis. Vitrectomy for PDR also tended to contribute independently to early hemodialysis initiation. CONCLUSION: A high max BMI contributed to early hemodialysis initiation independent of diabetes. Furthermore, PDR was associated with a high max BMI and early hemodialysis initiation. These results suggest that weight reduction in young chronic kidney disease patients with obesity may prevent hemodialysis and blindness.
Authors: Haroon L Chughtai; Timothy M Morgan; Michael Rocco; Brandon Stacey; Tina E Brinkley; Jingzhong Ding; Barbara Nicklas; Craig Hamilton; W Gregory Hundley Journal: Hypertension Date: 2010-09-13 Impact factor: 10.190
Authors: Holly J Kramer; Anand Saranathan; Amy Luke; Ramone A Durazo-Arvizu; Cao Guichan; Susan Hou; Richard Cooper Journal: J Am Soc Nephrol Date: 2006-04-05 Impact factor: 10.121
Authors: Philip R Schauer; Deepak L Bhatt; John P Kirwan; Kathy Wolski; Ali Aminian; Stacy A Brethauer; Sankar D Navaneethan; Rishi P Singh; Claire E Pothier; Steven E Nissen; Sangeeta R Kashyap Journal: N Engl J Med Date: 2017-02-16 Impact factor: 91.245
Authors: Elisabeth Ejerblad; C Michael Fored; Per Lindblad; Jon Fryzek; Joseph K McLaughlin; Olof Nyrén Journal: J Am Soc Nephrol Date: 2006-04-26 Impact factor: 10.121
Authors: A Saiki; D Nagayama; M Ohhira; K Endoh; M Ohtsuka; N Koide; T Oyama; Y Miyashita; K Shirai Journal: Int J Obes (Lond) Date: 2005-09 Impact factor: 5.095
Authors: Chi-yuan Hsu; Charles E McCulloch; Carlos Iribarren; Jeanne Darbinian; Alan S Go Journal: Ann Intern Med Date: 2006-01-03 Impact factor: 25.391