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Titolo Serum Creatinine Improves Body Mass Index Survival Prediction in Hemodialysis Patients: A 1-Year Prospective Cohort Analysis From the ARNOS Study
Autore Xavier Moreau-Gaudry, MD,* Fitsum Guebre-Egziabher, MD,† Guillaume Jean, MD,± Leslie Genet,§ Dominique Lataillade, MD,{ Eric Legrand, MD,** Francois Kuentz, MD,†† Pierre Trolliet, MD,±± and Denis Fouque, MD, PhD†
Referenza Journal of Renal Nutrition 2011; doi:10.1053/j.jrn.2010.08.005
Contenuto Objective: This study sought to better characterize the relationships between body mass index (BMI) and lean body mass (LBM) as assessed by serum creatinine (SCr) and mortality. Design: The data were collected from a prospective prevalent cohort in maintenance hemodialysis patients. Setting: The study was carried out in 25 dialysis units in Rh^ones Alpes area (France and Switzerland). Patient: A total of 1,205 patients were followed up for 1-year, starting July 1, 2005. Outcome: Mortality as well as clinical and biological routine parameters were recorded. Kaplan-Meier, Cox model, Log rank test were used for the statistical analysis. Results: We found that SCr was a strong predictor of mortality (P , .001), whereas BMI was not. Additionally, higher BMI lost its protective effect when it was associated with low SCr. Survival was strongly reduced in patients having a predialysis SCr ,717 mmol/L in patients with a BMI .23 (P , .001). Conclusion: BMI should not be used by itself but in conjunction with SCr as a surrogate of LBM to improve its morbid-mortality predictive power. LBM should also be taken into account in further survival studies carried out in hemodialysis patients.
Data 02.03.2011
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