Abstract P314: Moderate to Severe Thinness was Strongly Associated with High Risks of Cardiovascular and Infectious Disease-related Death and Incident Stroke Among Japanese Hemodialysis Patients

Abstract

Background: Overweight and obese is shown to be associated with a high risk for cardiovascular morbidity and mortality in the general population. While, inverse relationship between body mass index (BMI) and a risk for all-cause death was observed in dialysis patients. Thinner dialysis patients are supposed to be a high risk population. However, whether cardiovascular death contributes to a high risk for all-cause mortality or whether non-cardiovascular death contributes to a high risk for all-cause mortality in thinner dialysis patients has not been fully elucidated. Methods: A population-based prospective study of adult hemodialysis patients was carried out. A total of 1209 male and female hemodialysis patients were enrolled and divided into four groups according to BMI (G1: BMI < 17.0; G2: 17.0 ≤ BMI < 18.5; G3: 18.5 ≤ BMI < 25.0; G4: BMI ≥ 25.0 kg/ m 2 ). Main outcomes were all-cause death (ACD), cardiovascular death (CVD), infectious disease-related death (IFD), malignant disease-related death (MAD), incident acute myocardial infarction (AMI) and stroke. Sex- and age-adjusted mortality and incidence rates were estimated in the groups using Poisson’s regression analysis. Results: A total of 453 patients died during the 5 year observation period (4,790 person-years). Overweight (BMI ≥ 25.0 kg/ m 2 ) was not associated with a high risk for ACD, CVD, IFD, MAD, AMI and stroke, while moderate to severe thinness was strongly associated with excessive risks of ACD, CVD, IFD and stroke. Associations between BMI and risks for MAD and AMI were not observed (see table). Conclusion: Skinny hemodialysis patients are supposed to be a high risk population for infectious disease-related and stroke-related death and the findings should be known to hemodialysis patients and their caretakers.