Association of Body Composition with Survival Among Patients on Hemodialysis

[摘要] Several years ago, an “obesity paradox” was reported among several different cohorts of patients who were on dialysis (1–4). It soon became apparent that patients with high body mass index (BMI), even at levels considered obese and morbidly obese, had better survival than patients whose BMI was in the normal range (5). Although BMI is strongly correlated with percentage of body fat, including among patients who are on dialysis, it does not allow for the separation of fat and lean in an individual because it is calculated only from height and weight. Nevertheless, the improved survival among even those with extremely high BMI suggested that being fatter was truly advantageous. Individuals with higher BMI and higher body fat usually also have higher lean body mass than those with low BMI, so the question of which component of body composition—fat or lean—is associated (or is more associated) with the observed obesity paradox became a point of debate, contention, and, of course, further research.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome