Obesity in a chronic hemodialysis population

Abstract

Objective: To estimate the prevalence of obesity in the chronic hemodialysis (CHD) population and determine the effect of obesity on the morbidity and mortality in these patients. Design: Retrospective survey with some prospective elements. Setting: Four free-standing outpatient dialysis units. Patients: Of 296 CHD patients screened, 60 obese CHD patients (≥120% ideal body weight and body mass index ≥28) were identified, including 34 males and 26 females of ages 44 to 84 years. The control group included 60 nonobese CHD patients (90% to 110% ideal body weight and body mass index >19 and <28), including 34 males and 26 females ages 43 to 83 years. Interventions: A noninterventional study; routinely collected demographic, anthropometric, bioelectrical impedance analysis, biochemical, urea kinetic, and clinical data were analyzed. Main outcome measures: Comparison of the existence of comorbidities, hospitalization, and mortality in obese and nonobese CHD patients. Results: Obesity is prevalent in 20% of the CHD population. In obese versus nonobese patients, there was an increased incidence of diabetes mellitus in obese patients (48% v 30%), a higher percentage of patients at increased risk of developing coronary heart disease as determined by lipid profiles (52.9% v 36.7%), an increased hospitalization rate (mean annualized hospital days, 35.52 v 17.6 days per year), and increased death rate (5 v 3 incidents), respectively. Conclusion: Increased morbidity and mortality was observed in the obese CHD patients. Further study is warranted to determine the impact of diet, exercise, and physical training on morbidity and mortality in this group of patients.