ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: FR-PO822

Subcutaneous Fat Area Can Predict Two-Year Survival in ESRD Patients Initiating Dialysis

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Author

  • Choi, Wonjung, The Catholic University of Korea, Daejeon, Korea (the Republic of)
Background

Obesity is a risk factor for increased cardiovascular disease and diabetes in general population. However, the "obesity paradox" is observed in chronic disease such as ESRD patients. BMI does not discriminate between subcutaneous fat, visceral fat or muscle. Either overhydration or PEW state in the initial dialysis patient makes it difficult to properly assess BMI and muscle mass, the initial measurement of this modality difficult to assess the patient's prognosis. Fat tissue can be assessed relatively accurate than muscle even in patients starting dialysis. However, the association of fat tissue or the distribution of fat and mortality in ESRD patient not established yet.
The aim of this study was to investigate the association subcutaneous fat and all-cause mortality in initial dialysis patient.

Methods

total 123 patient newly initiated maintenance hemodialysis who underwent abdominal CT were enrolled between January 2018 and June 2021.Patient with age ≥18year were include. Subcutaneous fat area (SFA) were determined using abdominal CT. The analysis was conducted using open-source software to identify SFA in CT images for body composition analysis.

Results

During the 2-year follow-up period, the Kaplan–Meier survival rates were 67.8%, 87.5% in low SFA group (group 1) and high SFA group (group 2) (log rank p=0.005), respectively (Figure1). In Cox proportional hazards analysis, adjusting for (Model 1)+ CONUT, PNI as nutritional risk evaluation, low SFA group showed high risk for all-cause mortality (HR 2.979, 95% CI 1.137-7.808, p= 0.026) (Table 1).

Conclusion

In conclusion, low SFA increases the risk of 2-year all-cause mortality, suggesting that early SFA analysis may be predictive of mortality in patient risk analysis in initial dialysis populations.

K-M survival curve between SFA groups

Cox regression for SFA groups