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Extended hemodialysis without dietary restrictions may increase BMI, survival odds
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Use of extended hemodialysis without dietary restrictions may lead to positive effects of maintained or increased BMI and an increased rate of survival, according to recently published findings.
Manabu Hishida, MD, and colleagues aimed to evaluate BMI changes over time and the mortality risk in patients who underwent extended-hours hemodialysis without dietary restrictions.
“Several studies have shown an association between extended-hours hemodialysis and low mortality rates, decreased left ventricular mass and better regulation of both serum phosphorus and parathyroid hormone,” Hishida, of the department of nephrology at the Nagoya University Graduate School of Medicine at the Kamone Clinic in Japan, and colleagues wrote. “However, these studies focused on the removal of substances. In contrast, extended-hours hemodialysis with no dietary restrictions is a novel strategy, because it enables patients to eat sufficiently, leading to an increase in BMI, which can help improve the outcomes in patients with ESRD.”
Researchers conducted a retrospective cohort study of 187 patients (median age, 61 years; 107 were men) who received combined therapy extended-hours hemodialysis without dietary restrictions. The primary outcome of the study was all-cause mortality. Patients were categorized into groups by change in BMI of greater than or equal to 0 (n = 138) and change in BMI of less than 0.
Maintained BMI was associated with a hazard ratio of 0.45 for all-cause mortality, whereas increased BMI was associated with a hazard ratio of 0.35 during a follow-up of 4.9 years.
Investigators found BMI that increased or was maintained was associated with lower mortality rates in women, patients 65 years or older and patients without diabetes.
The presence of diabetes could impact the association between BMI variation and mortality, the researchers wrote. – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.
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