Body mass index as a predictor of continued survival in older chronic dialysis patients

被引:34
作者
Kutner N.G. [1 ]
Zhang R. [2 ]
机构
[1] Department of Rehabilitation Medicine, Emory University, School of Medicine, Atlanta, GA 30322
[2] Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA
基金
美国国家卫生研究院;
关键词
Aging; Body mass index; Dialysis; Mortality; Nutrition; Race;
D O I
10.1023/A:1017581726362
中图分类号
学科分类号
摘要
Objective: To investigate the contribution of body mass index (BMI) to mortality over 11 years of follow-up in a prevalent sample of dialysis patients aged 60+. Design: Multivariate Cox proportional hazards regression analysis. Setting: Multicenter stratified random sample of black and white older chronic dialysis patients in a southeastern state. Subjects: 316 patients on hemodialysis (HD) and peritoneal dialysis (PD). Main outcome measure: Continued survival from baseline interview in 1988 to June 1999. Results: Adjusting for age, primary diagnosis of diabetes, cardiovascular comorbidity, HD/PD therapy, and patient-reported functional impairment, the interaction of baseline BMI with race and gender was associated with older patients' risk of mortality. Black females, black males, and white males with higher BMI had a reduced risk of mortality, while no protective effect of higher BMI was found for white females. Patients with cardiovascular comorbidity and greater functional impairment at baseline had increased mortality risk. BMI was not significantly correlated with serum albumin or functional impairment. Conclusion: BMI, a simple anthropometric measure that provides a marker of nutritional status, interacts with race and gender to predict long-term survival in older dialysis patients. The association of survival with dialysis adequacy, nutritional indicators, and cardiovascular status in black and white dialysis patients is an important area of study.
引用
收藏
页码:441 / 448
页数:7
相关论文
共 32 条
  • [1] Manson J.E., Willett W.C., Stampfer M.U., Et al., Body weight and mortality among women, N Engl J Med, 333, pp. 677-685, (1995)
  • [2] Diehr P., Bild D.E., Harris T.B., Et al., Body mass index and mortality in non-smoking older adults: The cardiovascular health study, Am J Public Health, 88, pp. 623-629, (1998)
  • [3] Stevens J., Cai J., Pamuk E.R., Et al., The effect of age on the association between body-mass index and mortality, N Engl J Med, 338, pp. 1-7, (1998)
  • [4] Calle E.E., Thun M.J., Petrelli J.M., Rodriguez C., Heath C.W. Jr., Body-mass index and mortality in a prospective cohort of U.S. adults, N Engl J Med, 341, pp. 1097-1105, (1999)
  • [5] Allison D.B., Gallagher D., Heo M., Pi-Sunyer F.X., Heymsfield S.B., Body mass index and all-cause mortality among people age 70 and over: The longitudinal study on aging, Int J Obes Relat Metab Disord, 21, pp. 424-431, (1997)
  • [6] Di Carlo A., Baldereschi M., Maggi S., Scarlato G., Inzitari D., Body-mass index and all-cause mortality in older people: The Italian longitudinal study on aging, J Am Geriatr Soc, 47, (1999)
  • [7] Landi F., Zuccala G., Gambassi G., Et al., Body mass index and mortality among older people living in the community, J Am Geriatr Soc, 47, pp. 1072-1076, (1999)
  • [8] Reynolds M.W., Fredman L., Langenberg P., Magaziner J., Weight, weight change, and mortality in a random sample of older community-dwelling women, J Am Geriatr Soc, 47, pp. 1409-1414, (1999)
  • [9] Leavey S.F., Strawderman R.L., Jones C.A., Port F.K., Held P.J., Simple nutritional indicators as independent predictors of mortality in hemodialysis patients, Am J Kidney Dis, 31, pp. 997-1006, (1998)
  • [10] Wolfson M., Management of protein and energy intake in dialysis patients, J Am Soc Nephrol, 10, pp. 2244-2247, (1999)