Body mass index for chronic hemodialysis patients: Stable hemodialysis andmortality

Body mass index (BMI) is used as a reference for weight control programs in the general population and in morbidity and mortality studies in diabetes patients. However, the implications of BMI in chronic hemodialysis patients is unclear. We studied the BMI of chronic hemodialysis patients, focusing on problems encountered during outpatient hemodialysis therapy and on 2-yea r mortality. Outpatients with chronic hemodialysis (n = 258; 144 men, 114 w omen) were divided into four groups: (i) patients with stable hemodialysis; (ii) patients with marked hypotension requiring catecholamine infusion dur ing hemodialysis; (iii) patients with excessive interdialysis weight gain r equiring occasional additional hemodialysis; and (iv) patients with trouble some hemodialysis due to other causes. The statistical differences between the average BMI among these groups were evaluated, and were subdivided into sex, age and the duration of hemodialysis history. The 2-year mortality ra tes of these patients were also studied according to their BMI. In patients under 60 years of age, those with excessive interdialysis weight gain had statistically larger BMI (23.2; n = 35) compared to patients with good hemo dialysis control (20.1; n = 178), regardless of gender and hemodialysis his tory. The mortality rate was at a minimum at approximately 20 BMI in patien ts under 60 years of age. However, lower BMI was associated with a greater mortality rate in patients 60 years or over. For chronic hemodialysis patie nts, the BMI associated with stable hemodialysis and minimum mortality is a pproximately 20, in those under 60 years of age. The BMI of aged hemodialys is patients should be considered separately in morbidity and mortality stud ies.