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 Rhônes 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 μmol/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.
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