Hemodialysis modality, percentage of body fat, and patient survival

A number of studies have reported lower mortality of overweight hemodialysis patients. This post hoc analysis of an observational prospective single-center study was aimed at elucidating whether both being overweight and surviving longer could result from changes in the hemodialysis modality. The st...

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Bibliographic Details
Published in:International journal of artificial organs 2009-01, Vol.32 (1), p.20-30
Main Authors: Stosovic, M, Stanojevic, M, Radovic, M, Simic-Ogrizovic, S, Lezaic, V, Naumovic, R, Jovanovic, D, Ristic, G, Djukanovic, L, Marinkovic, J
Format: Article
Language:English
Subjects:
Acetates
Adiposity
Adult
Aged
Bicarbonates
Cellulose - analogs & derivatives
Dialysis Solutions - chemistry
Dialysis Solutions - therapeutic use
Female
Humans
Kidney Diseases - mortality
Kidney Diseases - physiopathology
Kidney Diseases - therapy
Male
Membranes, Artificial
Middle Aged
Nutritional Status
Overweight - etiology
Overweight - mortality
Overweight - physiopathology
Polymers
Proportional Hazards Models
Prospective Studies
Renal Dialysis - adverse effects
Renal Dialysis - methods
Renal Dialysis - mortality
Risk Assessment
Risk Factors
Sulfones
Survival Analysis
Time Factors
Treatment Outcome
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Summary:A number of studies have reported lower mortality of overweight hemodialysis patients. This post hoc analysis of an observational prospective single-center study was aimed at elucidating whether both being overweight and surviving longer could result from changes in the hemodialysis modality. The study included a cohort of 242 patients who were gradually switched from cuprophane membrane and acetate dialysis to polysulfone (including high-flux) membranes and bicarbonate dialysis. The analysis involved 12 months of baseline data obtained during the first calendar year after the patients entered the study (1994-2001) and repeated measurements for up to 132 months of follow-up (until 2004). Anthropometric measurements were made during the winter season and the percentage of body fat (%fat) was calculated from triceps, biceps, subscapular, and suprailiac skinfolds (K/DOQI guidelines).Kt/V, normalized protein catabolic rate, and cardiovascular comorbidity were also determined and laboratory analyses undertaken. Significant correlations were found between %fat and bicarbonate dialysate as well as polysulfone membrane and high-flux membrane. The linear mixed model showed dependence of %fat on polysulfone and high-flux membrane (p
ISSN:0391-3988
1724-6040
DOI:10.1177/039139880903200103