Associations of body fat and its changes over time with quality of life and prospective mortality in hemodialysis patients

Kalantar‐Zadeh, Kamyar; Kuwae, Noriko; Wu, Dennis Y.; Shantouf, Ronney; Fouque, Denis; Anker, Stefan D.; Block, Gladys; Kopple, Joel D.

doi:10.1093/ajcn/83.2.202

Cited by 303 publications

(270 citation statements)

References 42 publications

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“…Biceps and triceps skinfold thicknesses were measured with a conventional skinfold caliper using standard techniques as described previously (27,28). To estimate the percentage of body fat, portable near infrared interactance was used at the same time as the anthropometric measurements (29,30).…”

Section: Anthropometric and Body Composition Measuresmentioning

confidence: 99%

Association of Dietary Phosphorus Intake and Phosphorus to Protein Ratio with Mortality in Hemodialysis Patients

Noori¹,

Kalantar-Zadeh²,

Kövesdy³

et al. 2010

Clinical Journal of the American Society of Nephrology

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194

125

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Background and objectives: Epidemiologic studies show an association between higher predialysis serum phosphorus and increased death risk in maintenance hemodialysis (MHD) patients. The hypothesis that higher dietary phosphorus intake and higher phosphorus content per gram of dietary protein intake are each associated with increased mortality in MHD patients was examined.Design, setting, participants, & measurements: Food frequency questionnaires were used to conduct a cohort study to examine the survival predictability of dietary phosphorus and the ratio of phosphorus to protein intake. At the start of the cohort, Cox proportional hazard regression was used in 224 MHD patients, who were followed for up to 5 years (2001 to 2006).Results: Both higher dietary phosphorus intake and a higher dietary phosphorus to protein ratio were associated with significantly increased death hazard ratios (HR) in the unadjusted models and after incremental adjustments for case-mix, diet, serum phosphorus, malnutrition-inflammation complex syndrome, and inflammatory markers. The HR of the highest (compared with lowest) dietary phosphorus intake tertile in the fully adjusted model was 2.37. Across categories of dietary phosphorus to protein ratios of <12, 12 to <14, 14 to <16, and >16 mg/g, death HRs were 1.13, 1.00 (reference value), 1.80, and 1.99, respectively. Cubic spline models of the survival analyses showed similar incremental associations.Conclusions: Higher dietary phosphorus intake and higher dietary phosphorus to protein ratios are each associated with increased death risk in MHD patients, even after adjustments for serum phosphorus, phosphate binders and their types, and dietary protein, energy, and potassium intakes.

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Section: Anthropometric and Body Composition Measuresmentioning

confidence: 99%

Association of Dietary Phosphorus Intake and Phosphorus to Protein Ratio with Mortality in Hemodialysis Patients

Noori¹,

Kalantar-Zadeh²,

Kövesdy³

et al. 2010

Clinical Journal of the American Society of Nephrology

Self Cite

194

125

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show abstract

“…Considering the above evidence about the overwhelmingly deleterious effects of obesity on various disease processes, it is seemingly counterintuitive that obesity has been consistently associated with lower mortality rates in patients with advanced CKD [19,61] and ESRD [62,63]. Similar "paradoxical" associations have also been described in other populations, such as in patients with congestive heart failure [64], chronic obstructive pulmonary disease [65], rheumatoid arthritis [66], and even in old individuals [67].…”

Section: Mechanisms Of Action Underlying the Renal Effects Of Obesitymentioning

confidence: 92%

“…Higher muscle mass has also been shown to explain at least some of the positive effects attributed to elevated BMI [64,68]. However, there is also evidence to suggest that higher adiposity, especially subcutaneous (non-visceral) fat, may also be associated with better outcomes in ESRD patients [62]. Such benefits may indeed be present in patients who have very low short term life expectancy, such as most ESRD patients [69].…”

Section: Mechanisms Of Action Underlying the Renal Effects Of Obesitymentioning

confidence: 99%

Obesity and kidney disease: hidden consequences of the epidemic

2017

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“…Several epidemiologic studies have shown a strong relationship between obesity and increased risk of cardiovascular disease and mortality in the general population [22][23]. Nevertheless, several studies have indicated a J or U curve effect in individuals with a low BMI [23][24][25].…”

Section: Obesity and Cholesterol Levels In Hd Patientsmentioning

confidence: 99%

Cardiovascular Morbidity in Hemodialysis: The Reverse Epidemiology Phenomenon

Tsangalis¹

2011

Special Problems in Hemodialysis Patients

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Associations of body fat and its changes over time with quality of life and prospective mortality in hemodialysis patients

Cited by 303 publications

References 42 publications

Association of Dietary Phosphorus Intake and Phosphorus to Protein Ratio with Mortality in Hemodialysis Patients

Association of Dietary Phosphorus Intake and Phosphorus to Protein Ratio with Mortality in Hemodialysis Patients

Obesity and kidney disease: hidden consequences of the epidemic

Cardiovascular Morbidity in Hemodialysis: The Reverse Epidemiology Phenomenon

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