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Author Interview: Dr. Ellen K. Hoogeveen

Department of Internal Medicine and Nephrology,
Jeroen Bosch Hospital, Postbox 90153, 5200 ME,'s-Hertogenbosch
The Netherlands

Publication:

Obesity and Mortality Risk among Younger Dialysis Patients

Ellen K. Hoogeveen, Nynke Halbesma, Kenneth J. Rothman, Theo Stijnen, Sandra van Dijk, Friedo W. Dekker, Elisabeth W. Boeschoten, Renée de Mutsert for the Netherlands Cooperative Study on the Adequacy of Dialysis-2, 
(NECOSAD) Study, and Group
CJN.05700611; published ahead of print January 5, 2012,doi:10.2215/CJN.05700611

What are the main findings of the study?

The study followed 1,749 dialysis patients until they had a transplant or died, or for a maximum of seven years. All patients were to begin dialysis when the study started.

This study investigated the extent to which the relation of body mass index (BMI) and mortality differs between younger and older dialysis patients.

 We found a higher risk of mortality for both the obesity (BMI ≥30 kg/m2) and underweight (BMI<20 kg/m2) dialysis patients younger than 65 years. 

Younger obese dialysis patients had a 70 percent greater risk of dying in seven years than young patients with a normal weight. The relation between obesity and mortality was even more pronounced among patients younger than 50 years: they had a more than twofold increased mortality rate.

There was no higher risk of death for obese patients over 65.

Were any of the findings unexpected?

Our finding that obesity is a risk factor for mortality among younger dialysis patients is a paradigm shift.

Until recently it has been suggested that something called the "obesity paradox" protects obese dialysis patients.

What should clinicians and patients take away from this study?

The clinical implications of this study are as follows:

  1. First, that potential kidney recipients younger than 65 years on dialysis treatment should be encouraged to lose weight if obese.

  2. Second, for patients younger than 65 years, who are not eligible for kidney transplantation, identification of potential modifiable cardiovascular risk factors, such as obesity, is important to improve life expectancy.

What recommendations do you have for future studies as a result of your study?

Future research could focus on the most effective and healthy way to strive for normal weight among younger dialysis patients.

More Author Interviews from Hemodialysis.com
More on Weight Issues in CKD and Hemodialysis
More on Mortality Risk Factors in CKD and Hemodialysis
More on Weight Control, including Research Author Interviews, on WeightControl.com

 

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