Kidney Week

Abstract: SA-PO860

Association Between Body Mass Index and the Incidence of Cardiovascular Disease in Patients Undergoing Hemodialysis: Ten-Years Outcome of the Q-Cohort Study

Session Information

• Dialysis: Cardiovascular, BP, Volume
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Kawai, Yasuhiro, Kyushu University, Graduate School of Medical Sciences, Fukuoka City, FUKUOKA, Japan

Yasuhiro Kawai,

• Hiyamuta, Hiroto, Kyushu University, Graduate School of Medical Sciences, Fukuoka City, FUKUOKA, Japan

Hiroto Hiyamuta,

• Tanaka, Shigeru, Fukuoka Dental College, Fukuoka, Japan

Shigeru Tanaka,

• Taniguchi, Masatomo, Fukuoka Renal Clinic, Fukuoka, Japan

Masatomo Taniguchi,

• Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan

Kazuhiko Tsuruya,

• Nakano, Toshiaki, Kyushu University, Graduate School of Medical Sciences, Fukuoka City, FUKUOKA, Japan

Toshiaki Nakano,

• Kitazono, Takanari, Kyushu University, Graduate School of Medical Sciences, Fukuoka City, FUKUOKA, Japan

Takanari Kitazono,

Background

In hemodialysis (HD) patients, high body mass index (BMI) is paradoxically associated with better outcomes including a lower risk of cardiovascular and all-cause mortality (obesity paradox). However, the impact of BMI on the incidence of cardiovascular disease (CVD) [stroke, ischemic heart disease (IHD), or peripheral artery disease (PAD)] in patients undergoing hemodialysis remains unclear.

Methods

A total of 3,506 participants undergoing maintenance HD were followed up for 10 years. The primary outcome was the incidence of stroke, IHD, or PAD. The subjects were divided into 4 groups based on the quartile of the baseline BMI values (Q1, ≤19.1; Q2, 19.2–20.9; Q3, 21.0–22.6; Q4, ≥22.7 kg/m²). The association between BMI and the incidence of each CVD was examined using Cox proportional hazards model.

Results

During the follow-up period, 526 (15%), 456 (13%), and 257 (7.3%) patients experienced stroke, IHD, and PAD, respectively. The 10-year incidence rate of stroke was significantly higher with lower BMI, whereas incidence rates of IHD and PAD were significantly lower with lower BMI. Compared with the highest quartile of BMI (Q4), the multivariable-adjusted hazard ratios (95% confidence interval) for stroke were 1.45 (1.13–1.85) in patients with Q1. Whereas, compared with the lowest quartile of BMI (Q1), the multivariable-adjusted hazard ratios (95% confidence intervals) for IHD and PAD were 2.04 (1.54–2.72) and 1.76 (1.21–2.55) in patients with Q4, respectively.

Conclusion

Low BMI was associated with high risk of stroke, whereas high BMI was associated with high risk of IHD and PAD in patients undergoing HD. Our results suggest that the influence of BMI on the incidence of CVD may be different depending on the type of cardiovascular events.

Funding

• Government Support - Non-U.S.