Abstract
The reverse epidemiology in chronic kidney disease associates obesity with an improvement in survival in patients on dialysis. However, many studies are based on body mass index, an anthropometric method that does not differ lean mass and fat mass, generating controversy. Thus, the analysis of body composition is made necessary to check the veracity of obesity as a protective factor in these patients. The goal of this paper was to review articles that deal with body composition as a mortality protective factor in patients on dialysis treatment. It is a systematic review involving 33 articles, with the following descriptors: Dialysis, body composition, anthropometry and mortality. Through the present studies, it can be concluded that both body mass index and body composition are strong predictors of death. However, the protective effect granted to the high body mass index, indicated in reverse epidemiology, is limited to patients with normal or high muscle mass. Patients with high body mass index due to high body fat present a higher risk of mortality. Therefore, because it does not distinguish lean body mass and fat body mass, the body mass index should not be the manly method evaluation of nutritional state used in patients with chronic kidney disease.
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