- 作者：Xavier Moreau-Gaudry ; MD&lowast ; ; xmg@agduc.com ; Fitsum Guebre-Egziabher ; MD&dagger ; ; Guillaume Jean ; MD&Dagger ; ; Leslie Genet§ ; ; Dominique Lataillade ; MD¶ ; ; Eric Legrand ; MD&lowast ; &lowast ; ; Francois Kuentz ; MD&dagger ; &dagger ; ; Pierre Trolliet ; MD&Dagger ; &Dagger ; ; Denis Fouque ; MD ; PhD&dagger ;
- 刊名：Journal of Renal Nutrition
- 出版年：2011
- 出版时间：September 2011
- 年：2011
- 卷：21
- 期：5
- 页码：369-375
- 全文大小：205 K
Objective
This study sought to better characterize the relationships between body mass index (BMI) and lean body mass (LBM) as assessed by serum creatinine (SCr) and mortality.Design
The data were collected from a prospective prevalent cohort in maintenance hemodialysis patients.
Setting
The study was carried out in 25 dialysis units in Rh?nes Alpes area (France and Switzerland).
Patient
A total of 1,205 patients were followed up for 1-year, starting July 1, 2005.
Outcome
Mortality as well as clinical and biological routine parameters were recorded. Kaplan¨CMeier, Cox model, Log rank test were used for the statistical analysis.
Results
We found that SCr was a strong predictor of mortality (P < .001), whereas BMI was not. Additionally, higher BMI lost its protective effect when it was associated with low SCr. Survival was strongly reduced in patients having a predialysis SCr <717 ¦Ìmol/L in patients with a BMI >23 (P < .001).
Conclusion
BMI should not be used by itself but in conjunction with SCr as a surrogate of LBM to improve its morbid¨Cmortality predictive power. LBM should also be taken into account in further survival studies carried out in hemodialysis patients.