Relationship Between Body Mass Index and Mortality in Adults on Maintenance Hemodialysis: A Systematic Review
Date
2010
Authors
Herselman M.
Esau N.
Kruger J.-M.
Labadarios D.
Moosa M.R.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Objective: The primary objective of this systematic review was to determine the relationship between body mass index (BMI) and all-cause and cardiovascular mortality. Design: Systematic review of primarily observational studies. Patients: Adult patients from all gender, race, or ethnic groups on maintenance hemodialysis. Methods: Medline, Science Citation Index, Academic Search Premier, Cochrane Library, and Embase electronic databases covering the period 1966 to December 2008 were searched with the help of a qualified librarian. Reference lists of included papers and collections also were searched. Each study was reviewed by 2 independent reviewers who also performed the data extraction from full papers. Differences between reviewers were resolved by consensus or by a third reviewer in the case of disagreements. The quality of studies selected for inclusion in the systematic review was also assessed by 2 independent reviewers. Main Outcomes: BMI and mortality. Results: Eighteen studies (60%) reported a significant inverse relationship between all-cause mortality and BMI. This inverse relationship was more prevalent in older patients, larger retrospective studies, and studies that did not adjust for inflammation. On the other hand, 57% of the 7 studies reporting on cardiovascular mortality found no significant relationship with BMI. Conclusions: This systematic review shows evidence of an inverse relationship between BMI and all-cause mortality in adult patients on maintenance HD, especially in older patients, but the relationship with cardiovascular mortality is less clear. © 2010 National Kidney Foundation, Inc.
Description
Keywords
adult, age distribution, body mass, cardiovascular disease, cause of death, chronic kidney failure, hospitalization, human, mortality, renal replacement therapy, retrospective study, review, risk, Adult, Age Distribution, Body Mass Index, Cardiovascular Diseases, Cause of Death, Humans, Kidney Failure, Chronic, Renal Dialysis, Retrospective Studies, Risk, Severity of Illness Index
Citation
Journal of Renal Nutrition
20
5
20
5