Abstract: SA-PO333
Obesity in Patients on Haemodialysis: Looking Beyond BMI
Session Information
- Hemodialysis and Frequent Dialysis: Potpourri
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Cooney, Sarah, Beaumont Hospital, Dublin, Ireland
- Conlon, Peter J., Beaumont Hospital, Dublin, Ireland
- Le roux, Carel W., University College Dublin, Dublin, Ireland
Background
Obesity has important implications for patients on dialysis for a number of reasons- from making them more complex to treat, to affecting the likelihood of transplantation. The WHO has changed the clinical definition of obesity from BMI >30kg/m2 to “abnormal or excessive fat that presents a risk to health”. While BMI, similar to eGFR, is useful as a screening tool, it does not always reflect health status in individuals and thus neither BMI nor eGFR are diagnostic tools. In clinical practice the King's Obesity Staging Criteria can be used to diagnose obesity by identifying complications of obesity to determine whether a patient would benefit from obesity treatment. Using the new WHO definition, patients who were previously classed as overweight (BMI >25kg/m2) who have a complication related to excess adipose tissue can be classed as having obesity and as such may benefit from obesity treatment. Equally some patients with a BMI >30kg/m2 may not have clinically definable obesity.
Methods
This was a retrospective, cross-sectional audit of the prevalence of obesity in patients on haemodialysis in Beaumont Hospital, Dublin. Weight and height were extracted from the renal electronic database, which was used as a screening tool to determine patients with a BMI >25kg/m2. The King's Obesity Staging criteria was then used to define if they had any complications of obesity.
Results
BMI was used as a screening tool on the current patients on haemodialysis (n=196). This identified 34.1% of patients as having obesity by the older definition of BMI >30kg/m2. In our series 62.5% of patients over BMI 25kg/m2 had a non-kidney disease related obesity complication and therefore using the new WHO definition 49.4% of the total patients on dialysis have obesity. Mean BMI was 28.4kg/m2. The most common complication was type two diabetes (n=58).
Conclusion
The disease of obesity affects 49.4% of patients on dialysis in Beaumont hospital. Evidence is now required to show whether treating obesity in this population will result in substantial health gain.